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Pattern of increasing HbA1c levels in patients with diabetes mellitus before clinical detection of pancreatic cancer - a population-based nationwide case-control study.
Acta Oncol 2015; 54(7):986-92AO

Abstract

BACKGROUND

Diabetes mellitus is a risk factor for pancreatic cancer. Impaired insulin resistance might precede the clinical detection of this cancer by several years.

METHODS

This was a nested case-control population-based study assessing the pattern of glycated hemoglobin (HbA1c) change before clinical detection of pancreatic cancer in a population of individuals with diabetes mellitus. All patients registered in the Swedish National Diabetes Register with a prescription of an anti-diabetic drug between 2005 and 2011 were identified. For each case of pancreatic cancer, 10 controls were randomly selected, matched for age, sex, and factors related to diabetes mellitus. Multivariable conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between HbA1c and pancreatic cancer.

RESULTS

In total, 391 cases and 3910 matched controls were identified. The risk of pancreatic cancer was increased more than two-fold in individuals with the highest HbA1c quartile compared with the lowest (OR 1.96, 95% CI 1.40-2.75). The risk of pancreatic cancer remained elevated when comparing the highest HbA1c quartile measured within five years from the clinical detection of pancreatic cancer to the lowest HbA1c quartile (p-value for trend < 0.05). No association was found between HbA1c and pancreatic cancer if HbA1c was measured > 5 years before the clinical detection of pancreatic cancer.

CONCLUSIONS

The pattern of increasing HbA1c in patients with diabetes mellitus preceded the clinical detection of pancreatic cancer by up to five years. These findings indicate that there is a lead time of several years during which the development of pancreatic cancer might be detectable through screening in patients with diabetes mellitus.

Authors+Show Affiliations

Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet , Stockholm , Sweden.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25734801

Citation

Sadr-Azodi, Omid, et al. "Pattern of Increasing HbA1c Levels in Patients With Diabetes Mellitus Before Clinical Detection of Pancreatic Cancer - a Population-based Nationwide Case-control Study." Acta Oncologica (Stockholm, Sweden), vol. 54, no. 7, 2015, pp. 986-92.
Sadr-Azodi O, Gudbjörnsdottir S, Ljung R. Pattern of increasing HbA1c levels in patients with diabetes mellitus before clinical detection of pancreatic cancer - a population-based nationwide case-control study. Acta Oncol. 2015;54(7):986-92.
Sadr-Azodi, O., Gudbjörnsdottir, S., & Ljung, R. (2015). Pattern of increasing HbA1c levels in patients with diabetes mellitus before clinical detection of pancreatic cancer - a population-based nationwide case-control study. Acta Oncologica (Stockholm, Sweden), 54(7), pp. 986-92. doi:10.3109/0284186X.2015.1006402.
Sadr-Azodi O, Gudbjörnsdottir S, Ljung R. Pattern of Increasing HbA1c Levels in Patients With Diabetes Mellitus Before Clinical Detection of Pancreatic Cancer - a Population-based Nationwide Case-control Study. Acta Oncol. 2015;54(7):986-92. PubMed PMID: 25734801.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pattern of increasing HbA1c levels in patients with diabetes mellitus before clinical detection of pancreatic cancer - a population-based nationwide case-control study. AU - Sadr-Azodi,Omid, AU - Gudbjörnsdottir,Soffia, AU - Ljung,Rickard, Y1 - 2015/03/03/ PY - 2015/3/4/entrez PY - 2015/3/4/pubmed PY - 2016/4/2/medline SP - 986 EP - 92 JF - Acta oncologica (Stockholm, Sweden) JO - Acta Oncol VL - 54 IS - 7 N2 - BACKGROUND: Diabetes mellitus is a risk factor for pancreatic cancer. Impaired insulin resistance might precede the clinical detection of this cancer by several years. METHODS: This was a nested case-control population-based study assessing the pattern of glycated hemoglobin (HbA1c) change before clinical detection of pancreatic cancer in a population of individuals with diabetes mellitus. All patients registered in the Swedish National Diabetes Register with a prescription of an anti-diabetic drug between 2005 and 2011 were identified. For each case of pancreatic cancer, 10 controls were randomly selected, matched for age, sex, and factors related to diabetes mellitus. Multivariable conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between HbA1c and pancreatic cancer. RESULTS: In total, 391 cases and 3910 matched controls were identified. The risk of pancreatic cancer was increased more than two-fold in individuals with the highest HbA1c quartile compared with the lowest (OR 1.96, 95% CI 1.40-2.75). The risk of pancreatic cancer remained elevated when comparing the highest HbA1c quartile measured within five years from the clinical detection of pancreatic cancer to the lowest HbA1c quartile (p-value for trend < 0.05). No association was found between HbA1c and pancreatic cancer if HbA1c was measured > 5 years before the clinical detection of pancreatic cancer. CONCLUSIONS: The pattern of increasing HbA1c in patients with diabetes mellitus preceded the clinical detection of pancreatic cancer by up to five years. These findings indicate that there is a lead time of several years during which the development of pancreatic cancer might be detectable through screening in patients with diabetes mellitus. SN - 1651-226X UR - https://www.unboundmedicine.com/medline/citation/25734801/Pattern_of_increasing_HbA1c_levels_in_patients_with_diabetes_mellitus_before_clinical_detection_of_pancreatic_cancer___a_population_based_nationwide_case_control_study_ L2 - http://www.tandfonline.com/doi/full/10.3109/0284186X.2015.1006402 DB - PRIME DP - Unbound Medicine ER -