Katherine De la Torre, Minkyo Song, Sarah Krull Abe, Md. Shafiur Rahman, Md. Rashedul Islam, Eiko Saito, Sukhong Min, Dan Huang, Yu Chen, Prakash C. Gupta, Norie Sawada, Akiko Tamakoshi, Xiao-Ou Shu, Wanqing Wen, Ritsu Sakata, Jeongseon Kim, Chisato Nagata, Hidemi Ito, Sue K. Park, Myung-Hee Shin, Mangesh S. Pednekar, Shoichiro Tsugane, Takashi Kimura, Yu-Tang Gao, Hui Cai, Keiko Wada, Isao Oze, Aesun Shin, Yoon-Ok Ahn, Habibul Ahsan, Paolo Boffetta, Kee Seng Chia, Keitaro Matsuo, You-Lin Qiao, Nathaniel Rothman, Wei Zheng, Manami Inoue, Daehee Kang
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引用次数: 0
Abstract
Background
Evidence suggests a possible link between diabetes and gastric cancer risk, but the findings remain inconclusive, with limited studies in the Asian population. We aimed to assess the impact of diabetes and diabetes duration on the development of gastric cancer overall, by anatomical and histological subtypes.
Methods
A pooled analysis was conducted using 12 prospective studies included in the Asia Cohort Consortium. Among 558 981 participants (median age 52), after a median follow-up of 14.9 years and 10.5 years, 8556 incident primary gastric cancers and 8058 gastric cancer deaths occurred, respectively. Cox proportional hazard regression models were used to estimate study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) and pooled using random-effects meta-analyses.
Results
Diabetes was associated with an increased incidence of overall gastric cancer (HR 1.15, 95% CI 1.06–1.25). The risk association did not differ significantly by sex (women vs men: HR 1.31, 95% CI 1.07–1.60 vs 1.12, 1.01–1.23), anatomical subsites (noncardia vs cardia: 1.14, 1.02–1.28 vs 1.17, 0.77–1.78) and histological subtypes (intestinal vs diffuse: 1.22, 1.02–1.46 vs 1.00, 0.62–1.61). Gastric cancer risk increased significantly during the first decade following diabetes diagnosis (HR 4.70, 95% CI 3.77–5.86), and decreased with time (nonlinear p < .01). Positive associations between diabetes and gastric cancer mortality were observed (HR 1.15, 95% CI 1.03–1.28) but attenuated after a 2-year time lag.
Conclusion
Diabetes was associated with an increased gastric cancer incidence regardless of sex, anatomical subsite, or subtypes of gastric cancer. The risk of gastric cancer was particularly high during the first decade following diabetes diagnosis.
背景:有证据表明,糖尿病与胃癌风险之间可能存在联系,但研究结果仍不确定,对亚洲人群的研究也很有限。我们旨在按解剖学和组织学亚型评估糖尿病和糖尿病持续时间对胃癌发病的总体影响:我们利用亚洲队列联合会(Asia Cohort Consortium)的 12 项前瞻性研究进行了汇总分析。在558 981名参与者(中位年龄为52岁)中,经过中位14.9年和10.5年的随访,分别有8556人发生原发性胃癌,8058人死于胃癌。研究人员使用考克斯比例危险回归模型估算了特定研究的危险比(HRs)和95%置信区间(CIs),并使用随机效应荟萃分析进行了汇总:糖尿病与总体胃癌发病率增加有关(HR 1.15,95% CI 1.06-1.25)。不同性别(女性 vs 男性:HR 1.31,95% CI 1.07-1.60 vs 1.12,1.01-1.23)、解剖亚部位(非贲门 vs 贲门:1.14,1.02-1.28 vs 1.17,0.77-1.78)和组织学亚型(肠型 vs 弥漫型:1.22,1.02-1.46 vs 1.00,0.62-1.61)的风险相关性差异不大。在糖尿病确诊后的头十年,胃癌风险明显增加(HR 4.70,95% CI 3.77-5.86),并随着时间的推移而降低(非线性 p 结论:糖尿病与胃癌风险增加有关:无论性别、解剖部位或胃癌亚型如何,糖尿病都与胃癌发病率增加有关。在糖尿病确诊后的头十年,患胃癌的风险尤其高。
期刊介绍:
Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation.
The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.