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Hyperglycaemia is associated with cancer-related but not non-cancer-related deaths: evidence from the IPC cohort.
Diabetologia. 2018 05; 61(5):1089-1097.D

Abstract

AIMS/HYPOTHESIS

Hyperglycaemia has been associated with the incidence of all and specific types of cancer, distinct from the risks related to diabetes. The relationships between blood glucose and mortality rates related to all and specific cancers were analysed in comparison with all-cause or non-cancer-related mortality rates in a large, general primary care population in France.

METHODS

Between January 1991 and December 2008, 301,948 participants (193,221 men and 108,727 women), aged 16-95 years (mean ± SD 44.8 ± 12.0 years for men and 45.1 ± 14.2 years for women), had a health check at the IPC Centre. All data collected in standard conditions during the health checks-up were used for statistical analysis All examinations were performed under fasting conditions and included a blood glucose measurement. Participants with known diabetes (<9%) were excluded from the analysis. Participants were classified into quintiles based on their blood glucose measurement and were followed for a maximum of 17 years (mean ± SD 9.2 ± 4.7 years) to assess all-cause, cancer and non-cancer mortality rates.

RESULTS

A non-linear relationship was observed between cancer mortality rates and blood glucose quintile after adjustment for age and sex. There was a significant association between the group with the highest blood glucose level and cancer-related death (multivariate Cox model, HR [95% CI] 1.17 [1.03, 1.34]), while the group with normoglycaemia showed no association with cancer-related deaths. We did not observe a relationship between blood glucose and all-cause or non-cancer mortality rates. An excess risk of death was observed in the highest blood glucose quintile for gastrointestinal cancer and leukaemia. Adjustments for diabetes and aspirin use did not modify the results. However, this excess risk disappeared with use of glucose-lowering agents (HR [95% CI] 1.03 [0.74, 1.43]).

CONCLUSIONS/INTERPRETATION

Hyperglycaemia is associated with significantly higher rates of cancer-related deaths, particularly in gastrointestinal cancer and leukaemia, but not with non-cancer-related deaths. The association is retained when taking into account confounding factors, including chronic aspirin treatment.

Authors+Show Affiliations

Centre IPC, 6-14 rue La Pérouse, 75016, Paris, France. Hopital Pitié Salpétrière, APHP, Paris, France.Centre IPC, 6-14 rue La Pérouse, 75016, Paris, France.Hopital HEGP, APHP, Paris, France. Hôpitaux Universitaires Paris Ouest, APHP, Paris, France.Centre IPC, 6-14 rue La Pérouse, 75016, Paris, France. Hopital Broca, APHP, Paris, France.Hopital HEGP, APHP, Paris, France. Hôpitaux Universitaires Paris Ouest, APHP, Paris, France. Inserm U894, Centre Psychiatrie et Neurosciences, Paris, France.Hopital Saint Antoine, APHP, Université Pierre et Marie Curie, Paris, France.Centre IPC, 6-14 rue La Pérouse, 75016, Paris, France. pannier@ipc.asso.fr. Hopital Manhès, Fleury-Merogis, France. pannier@ipc.asso.fr.Centre IPC, 6-14 rue La Pérouse, 75016, Paris, France. Hopital HEGP, APHP, Paris, France. Université Paris Descartes, Sorbonne Paris Cité, Faculté de médecine, Paris, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29305626

Citation

Simon, Jean-Marc, et al. "Hyperglycaemia Is Associated With Cancer-related but Not Non-cancer-related Deaths: Evidence From the IPC Cohort." Diabetologia, vol. 61, no. 5, 2018, pp. 1089-1097.
Simon JM, Thomas F, Czernichow S, et al. Hyperglycaemia is associated with cancer-related but not non-cancer-related deaths: evidence from the IPC cohort. Diabetologia. 2018;61(5):1089-1097.
Simon, J. M., Thomas, F., Czernichow, S., Hanon, O., Lemogne, C., Simon, T., Pannier, B., & Danchin, N. (2018). Hyperglycaemia is associated with cancer-related but not non-cancer-related deaths: evidence from the IPC cohort. Diabetologia, 61(5), 1089-1097. https://doi.org/10.1007/s00125-017-4540-8
Simon JM, et al. Hyperglycaemia Is Associated With Cancer-related but Not Non-cancer-related Deaths: Evidence From the IPC Cohort. Diabetologia. 2018;61(5):1089-1097. PubMed PMID: 29305626.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperglycaemia is associated with cancer-related but not non-cancer-related deaths: evidence from the IPC cohort. AU - Simon,Jean-Marc, AU - Thomas,Frederique, AU - Czernichow,Sebastien, AU - Hanon,Olivier, AU - Lemogne,Cedric, AU - Simon,Tabassome, AU - Pannier,Bruno, AU - Danchin,Nicolas, Y1 - 2018/01/05/ PY - 2017/09/13/received PY - 2017/12/01/accepted PY - 2018/1/7/pubmed PY - 2019/1/29/medline PY - 2018/1/7/entrez KW - Cancer KW - Epidemiology KW - Hyperglycaemia KW - Mortality SP - 1089 EP - 1097 JF - Diabetologia JO - Diabetologia VL - 61 IS - 5 N2 - AIMS/HYPOTHESIS: Hyperglycaemia has been associated with the incidence of all and specific types of cancer, distinct from the risks related to diabetes. The relationships between blood glucose and mortality rates related to all and specific cancers were analysed in comparison with all-cause or non-cancer-related mortality rates in a large, general primary care population in France. METHODS: Between January 1991 and December 2008, 301,948 participants (193,221 men and 108,727 women), aged 16-95 years (mean ± SD 44.8 ± 12.0 years for men and 45.1 ± 14.2 years for women), had a health check at the IPC Centre. All data collected in standard conditions during the health checks-up were used for statistical analysis All examinations were performed under fasting conditions and included a blood glucose measurement. Participants with known diabetes (<9%) were excluded from the analysis. Participants were classified into quintiles based on their blood glucose measurement and were followed for a maximum of 17 years (mean ± SD 9.2 ± 4.7 years) to assess all-cause, cancer and non-cancer mortality rates. RESULTS: A non-linear relationship was observed between cancer mortality rates and blood glucose quintile after adjustment for age and sex. There was a significant association between the group with the highest blood glucose level and cancer-related death (multivariate Cox model, HR [95% CI] 1.17 [1.03, 1.34]), while the group with normoglycaemia showed no association with cancer-related deaths. We did not observe a relationship between blood glucose and all-cause or non-cancer mortality rates. An excess risk of death was observed in the highest blood glucose quintile for gastrointestinal cancer and leukaemia. Adjustments for diabetes and aspirin use did not modify the results. However, this excess risk disappeared with use of glucose-lowering agents (HR [95% CI] 1.03 [0.74, 1.43]). CONCLUSIONS/INTERPRETATION: Hyperglycaemia is associated with significantly higher rates of cancer-related deaths, particularly in gastrointestinal cancer and leukaemia, but not with non-cancer-related deaths. The association is retained when taking into account confounding factors, including chronic aspirin treatment. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/29305626/Hyperglycaemia_is_associated_with_cancer_related_but_not_non_cancer_related_deaths:_evidence_from_the_IPC_cohort_ L2 - https://doi.org/10.1007/s00125-017-4540-8 DB - PRIME DP - Unbound Medicine ER -