Sunalie Silva all articles by this author
PREDIABETES, whether defined as impaired glucose tolerance or impaired fasting glucose, increases the risk of developing cancer by 15% compared to people who are normoglycaemic, researchers have claimed.
Researchers reviewed 16 studies that included nearly 900,000 people from around the world and found that people with prediabetes had a 15% overall increased risk of cancer.
The condition was significantly associated with increased risks of cancer of the stomach/colorectum (relative risk, RR 1.55), liver (RR 2.01), pancreas (RR 1.19), breast (RR 1.19) and endometrium (RR 1.60).
There was no link between prediabetes and lung, prostate, ovarian, kidney or bladder cancer.
According to the researchers, subgroup analyses showed no differences in cancer risk by sex, age or follow-up duration, but did reveal a significantly higher relative risk for Asian (1.50) than non-Asian patients (1.12).
In a sub-analysis that controlled for BMI, the presence of prediabetes and obesity was associated with a 22% increased risk of cancer.
Prediabetes was defined as impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or both.
IFG was defined as a fasting plasma glucose (FPG) range of 5.6–6.9mmol/L if the study used American Diabetes Association guidelines, or 6.1–6.9mmol/L if the study used World Health Organization guidelines.
IGT was defined as a two-hour plasma glucose of 7.8–11.1mmol/L during an oral glucose tolerance test.
But the authors warned that risk increased even in people with an FPG as low as 5.6mmol/L.
The authors suggest one mechanism that could explain the increased risk of cancer seen in people with prediabetes might be that hyperglycaemia and its related conditions, such as chronic oxidative stress, act as carcinogenic factors.
They also point out that the type 2 diabetes drug metformin is now increasingly being recognised as having some protective anticancer properties.
According to the researchers, metformin affords an approximately 30% reduction in the lifetime risk of cancer in diabetic patients — but whether this is true in prediabetic individuals is not yet known, they said.
“Long-term, large-scale studies of high-risk individuals, especially those with IGT or a combination of IGT and IFG, are urgently needed to explore the effects of metformin interventions on the risk of cancer in people with prediabetes.”
Diabetologia 2014; online 10 Sept
The condition was significantly associated with increased risks of cancer of the stomach/colorectum (relative risk, RR 1.55), liver (RR 2.01), pancreas (RR 1.19), breast (RR 1.19) and endometrium (RR 1.60).
There was no link between prediabetes and lung, prostate, ovarian, kidney or bladder cancer.
According to the researchers, subgroup analyses showed no differences in cancer risk by sex, age or follow-up duration, but did reveal a significantly higher relative risk for Asian (1.50) than non-Asian patients (1.12).
In a sub-analysis that controlled for BMI, the presence of prediabetes and obesity was associated with a 22% increased risk of cancer.
Prediabetes was defined as impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or both.
IFG was defined as a fasting plasma glucose (FPG) range of 5.6–6.9mmol/L if the study used American Diabetes Association guidelines, or 6.1–6.9mmol/L if the study used World Health Organization guidelines.
IGT was defined as a two-hour plasma glucose of 7.8–11.1mmol/L during an oral glucose tolerance test.
But the authors warned that risk increased even in people with an FPG as low as 5.6mmol/L.
The authors suggest one mechanism that could explain the increased risk of cancer seen in people with prediabetes might be that hyperglycaemia and its related conditions, such as chronic oxidative stress, act as carcinogenic factors.
They also point out that the type 2 diabetes drug metformin is now increasingly being recognised as having some protective anticancer properties.
According to the researchers, metformin affords an approximately 30% reduction in the lifetime risk of cancer in diabetic patients — but whether this is true in prediabetic individuals is not yet known, they said.
“Long-term, large-scale studies of high-risk individuals, especially those with IGT or a combination of IGT and IFG, are urgently needed to explore the effects of metformin interventions on the risk of cancer in people with prediabetes.”
Diabetologia 2014; online 10 Sept
No comments:
Post a Comment