背景:在糖尿病前期患者中,糖耐量受损(IGT)人群中2型糖尿病(T2D)与癌症风险之间的联系仍不确定.我们在奥克兰南部和西部初级保健的IGT个体中检查了这种关联,新西兰,从1994年到2019年,评估5年和10年的癌症风险。
方法:研究队列从奥克兰的糖尿病护理支持服务中提取,新西兰,将其与国家死亡登记处联系起来,癌症,入院,医药索赔,和社会经济地位。我们比较了在1-5年暴露窗口内新诊断的有或没有T2D的IGT个体的癌症风险。采用锥形匹配和界标分析来解决潜在的混杂效应,我们形成了IGT比较队列.然后使用加权Cox回归模型来评估T2D发病与5年和10年癌症风险之间的关联。
结果:该研究包括26,794例IGT患者,在5年内新诊断为T2D的629例,未诊断为T2D的13,007例。那些进展为T2D的患者有相似的5年癌症风险,但10年风险明显更高(HR1.35;95%CI1.09-1.68)。这种联系在老年人身上更强,社会经济上被剥夺的人,当前吸烟者,那些代谢指标较差的人,肾功能降低.新西兰欧洲种族的IGT患者10年癌症风险较低。
结论:T2D诊断影响IGT患者的癌症风险。制定高危IGT个体的风险评分,实施癌症筛查和结构化糖尿病预防,特别是在贫困或少数民族人口中,是必不可少的。
BACKGROUND: In people with prediabetes, the link between developing type 2 diabetes (T2D) and cancer risk among those with impaired glucose tolerance (IGT) remains uncertain. We examined this association in IGT individuals from primary care in South and West Auckland, New Zealand, spanning 1994-2019, assessing 5- and 10-year cancer risks.
METHODS: Study cohorts were extracted from the Diabetes Care Support Service in Auckland, New Zealand, linking it with national registries for death, cancer, hospital admissions, pharmaceutical claims, and socioeconomic status. We compared cancer risks in individuals with IGT newly diagnosed with or without T2D within a 1-5-year exposure window. Employing tapered matching and landmark analysis to address potential confounding effects, we formed comparative IGT cohorts. Weighted Cox regression models were then employed to assess the association between T2D onset and 5- and 10-year cancer risks.
RESULTS: The study included 26,794 patients with IGT, with 629 newly diagnosed with T2D within 5 years and 13,007 without such a diagnosis. Those progressing to T2D had similar 5-year cancer risk but significantly higher 10-year risk (HR 1.35; 95% CI 1.09-1.68). This association was stronger in older individuals, the socioeconomically deprived, current smokers, those with worse metabolic measures, and lower renal function. Patients with IGT of NZ European ethnicity had lower 10-year cancer risk.
CONCLUSIONS: T2D diagnosis influences cancer risk in individuals with IGT. Developing risk scores for high-risk IGT individuals and implementing cancer screening and structured diabetes prevention, especially in deprived or minority ethnic populations, is essential.