Impact of diabetes duration and chronic pancreatitis on the association between type 2 diabetes and pancreatic cancer risk
Impact of diabetes duration and chronic pancreatitis on the association between type 2 diabetes and pancreatic cancer risk
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DOI：
10.1111/j.1463-1326.2012.01667.x
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发表时间：
2012-12-01
影响因子：
5.8
通讯作者：
Goldstein, B. J.
中科院分区：
文献类型：
--
作者：
Brodovicz, K. G.;Kou, T. D.;Goldstein, B. J.
目的：为了研究糖尿病病程，慢性胰腺炎和其他因素对胰腺癌risk.Methods的影响：这项回顾性队列研究使用英国全科医学研究数据库比较胰腺癌的发病率和风险与2型糖尿病（T2 DM）与无糖尿病患者。采用多变量考克斯回归分析，校正年龄、性别、慢性胰腺炎史、胆囊疾病、肥胖、吸烟和饮酒以及Charlson合并症指数，以估计风险比（HR）[95%置信区间，CI]。结果：共确定了1903例胰腺癌，其中436例为T2 DM患者（78.76/100 000人-年[95% CI：71.54，86.51]），无糖尿病患者为1467例（11.46/100 000人-年[10.88，12.06]）。T2 DM（校正HR 1.80 [1.52，2.14]）、年龄增加、慢性胰腺炎病史和吸烟的胰腺癌风险显著。慢性胰腺炎和T2 DM患者的校正HR为12.12 [6.02，24.40]。T2 DM病程≥ 5年的患者发病率最高。在T2 DM病程>= 1至>= 5年的患者人群中，校正后的HR仍然显著，但随着T2 DM病程的延长，点估计值略有下降。结论：与非糖尿病患者相比，T2 DM患者发生胰腺癌的风险增加80%。患有T2 DM和慢性胰腺炎的患者患胰腺癌的可能性高12倍。
Aim: To examine the impact of diabetes duration, chronic pancreatitis and other factors on pancreatic cancer risk.Methods: This retrospective cohort study using the UK General Practice Research Database compared pancreatic cancer incidence and risk in patients with type 2 diabetes mellitus (T2DM) versus patients without diabetes. Multivariate Cox regression adjusting for age, sex, history of chronic pancreatitis, gallbladder disease, obesity, smoking and alcohol use and Charlson comorbidity index was used to estimate hazard ratio (HR) [95% confidence interval, CI]. Analyses were repeated using various time windows for diabetes duration.Results: A total of 1903 incident pancreatic cancers were identified, 436 in patients with T2DM (78.76 per 100 000 person-years [95% CI: 71.54, 86.51]) and 1467 in patients without diabetes (11.46 per 100 000 person-years [10.88, 12.06]). Pancreatic cancer risk was significant for T2DM (adjusted HR 1.80 [1.52, 2.14]), increasing age, history of chronic pancreatitis and tobacco use. For patients with chronic pancreatitis and T2DM, the adjusted HR was 12.12 [6.02, 24.40]. Incidence was highest in patients with >= 5 year duration of T2DM. In patient populations with duration of T2DM ranging from >= 1 to >= 5 years, adjusted HRs remained significant but point estimates attenuated slightly with longer duration of T2DM.Conclusions: Patients with T2DM had an 80% increased risk of pancreatic cancer versus patients without diabetes. Patients with T2DM and chronic pancreatitis were 12 times more likely to develop pancreatic cancer.