PURPOSE:Diabetes is a suspected risk factor for pancreatic cancer, but questions remain about whether it is a risk factor or a result of the disease. This study prospectively examined the association between diabetes and the risk of pancreatic adenocarcinoma in pooled data from the NCI pancreatic cancer cohort consortium (PanScan). METHODS:The pooled data included 1,621 pancreatic adenocarcinoma cases and 1,719 matched controls from twelve cohorts using a nested case-control study design. Subjects who were diagnosed with diabetes near the time (<2 years) of pancreatic cancer diagnosis were excluded from all analyses. All analyses were adjusted for age, race, gender, study, alcohol use, smoking, BMI, and family history of pancreatic cancer. RESULTS:Self-reported diabetes was associated with a forty percent increased risk of pancreatic cancer (OR = 1.40, 95 % CI: 1.07, 1.84). The association differed by duration of diabetes; risk was highest for those with a duration of 2-8 years (OR = 1.79, 95 % CI: 1.25, 2.55); there was no association for those with 9+ years of diabetes (OR = 1.02, 95 % CI: 0.68, 1.52). CONCLUSIONS:These findings provide support for a relationship between diabetes and pancreatic cancer risk. The absence of association in those with the longest duration of diabetes may reflect hypoinsulinemia and warrants further investigation.

译文

目的:糖尿病是怀疑为胰腺癌的危险因素,但有关它是该疾病的危险因素还是结果仍存在疑问。这项研究从NCI胰腺癌队列联合会(PanScan)收集的数据中前瞻性地检查了糖尿病与胰腺腺癌风险之间的关联。
方法:汇集的数据包括使用嵌套病例对照研究设计的来自十二个队列的1,621例胰腺腺癌病例和1,719例匹配的对照。所有分析均排除在胰腺癌诊断时间(<2年)内被诊断出患有糖尿病的受试者。所有分析均根据年龄,种族,性别,研究,饮酒,吸烟,BMI和胰腺癌家族史进行了调整。
结果:自我报告的糖尿病与胰腺癌风险增加40%相关(OR = 1.40,95%CI:1.07,1.84)。该关联因糖尿病持续时间而异;持续时间为2-8年的患者风险最高(OR = 1.79,95%CI:1.25,2.55);糖尿病9年没有相关性(OR = 1.02,95%CI:0.68,1.52)。
结论:这些发现为糖尿病与胰腺癌风险之间的关系提供了支持。糖尿病持续时间最长的患者缺乏相关性可能反映了低胰岛素血症,需要进一步研究。

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