2型糖尿病及其并发症与结直肠癌风险的关系

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology Pub Date : 2025-07-16 DOI:10.1016/j.canep.2025.102879

Eetu Mäkinen , Sanna Heikkinen , Janne Pitkäniemi , Karri Seppä

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引用次数: 0

摘要

21世纪，2型糖尿病（T2D）的患病率在全球范围内呈上升趋势。T2D和结直肠癌（CRC）有共同的危险因素，如肥胖。本研究旨在评估T2D与原发性CRC发病率的关系，以及糖尿病并发症与CRC风险的关系。方法：我们将来自卫生保健护理登记处的T2D严重程度（是否存在并发症）、超重、肥胖和酒精相关疾病的暴露数据以及来自芬兰癌症登记处的CRC病例与2000年至2017年随访的250万各年龄段芬兰人的随机样本联系起来。为了解释暴露的累积负担，我们采用了一个多状态模型，其中向CRC的过渡率用泊松回归建模，并根据年龄、自然期、性别、超重、肥胖和酒精相关疾病进行调整。结果该队列包括171,789名诊断为T2D的患者，诊断时的中位年龄为67.6岁。在整个队列中诊断的23533例crc中，2430例为糖尿病患者。诊断为T2D的个体患CRC的风险较高（风险比1.26,95 %置信区间1.20-1.32）。糖尿病合并症患者在T2D初始诊断后10年发生CRC的风险高于无合并症患者（1.21,1.02-1.45,p = 0.033）。患有糖尿病肾病的男性发生结直肠癌的风险明显高于没有肾病的糖尿病男性（1.51,1.23-1.86）。结论：我们的研究表明，非复杂性T2D患者在T2D诊断后的前10年内发生CRC的风险增加。在长期随访中，合并T2D的患者发生结直肠癌的风险也升高。

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The association of type 2 diabetes and its complications with the risk of colorectal cancer

Background

The prevalence of type 2 diabetes (T2D) has increased worldwide during the 21st century. T2D and colorectal cancers (CRC) share risk factors such as obesity. This study aims to estimate the association between T2D and the incidence of primary CRC, and furthermore the association of diabetic complications with the risk of CRC.

Methods

We linked exposure data on T2D by severity (presence or absence of complications), overweight and obesity and alcohol related disorders from Care Register for Health Care and CRC cases from the Finnish Cancer Registry to a random sample of 2.5 million Finnish individuals of all ages that were followed from 2000 to 2017. To account for the cumulative burden of exposures, we employed a multi-state model where transition rates to CRC were modeled with Poisson regression, adjusted for age, calendar period, sex, overweight and obesity and alcohol related disorders.

Results

The cohort included 171,789 people diagnosed with T2D, with a median age of 67.6 at diagnosis. From the 23 533 CRCs diagnosed in the entire cohort, 2430 were in people with diabetes. Individuals diagnosed with T2D were at a higher risk of CRC (Hazard ratio 1.26, 95 % confidence interval 1.20–1.32). Persons with diabetic complications had a higher risk of CRC than those without complications after 10 years since the initial T2D diagnosis (1.21, 1.02–1.45, p = 0.033). Men with diabetic nephropathy had a significantly higher risk of CRC (1.51, 1.23–1.86) than men with diabetes without nephropathy.

Conclusion

Our research shows that people with uncomplicated T2D are at an increased risk of CRC in the first 10 years after T2D diagnosis. The risk of CRC among individuals with complicated T2D remains elevated also in longer term follow-up.

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来源期刊

Cancer Epidemiology 医学-肿瘤学

CiteScore

4.50

自引率

3.80%

发文量

200

审稿时长

39 days

期刊介绍： Cancer Epidemiology is dedicated to increasing understanding about cancer causes, prevention and control. The scope of the journal embraces all aspects of cancer epidemiology including: • Descriptive epidemiology • Studies of risk factors for disease initiation, development and prognosis • Screening and early detection • Prevention and control • Methodological issues The journal publishes original research articles (full length and short reports), systematic reviews and meta-analyses, editorials, commentaries and letters to the editor commenting on previously published research.