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Associations of Hyperglycemia and Insulin Usage With the Risk of Cancer in Type 2 Diabetes: The Hong Kong Diabetes Registry

OBJECTIVE: Insulin has mitogenic effects, although hyperglycemia may be a risk factor for cancer in type 2 diabetes. It remains uncertain whether use of insulin increases cancer risk because of its effect on cell growth and proliferation or decreases cancer risk because of its glucose-lowering effec...

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Autores principales: Yang, Xilin, Ko, Gary T.C., So, Wing Yee, Ma, Ronald C.W., Yu, Linda W.L., Kong, Alice P.S., Zhao, Hailu, Chow, Chun-Chung, Tong, Peter C.Y., Chan, Juliana C.N.
Formato: Texto
Lenguaje:English
Publicado: American Diabetes Association 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2857906/
https://www.ncbi.nlm.nih.gov/pubmed/20185812
http://dx.doi.org/10.2337/db09-1371
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author Yang, Xilin
Ko, Gary T.C.
So, Wing Yee
Ma, Ronald C.W.
Yu, Linda W.L.
Kong, Alice P.S.
Zhao, Hailu
Chow, Chun-Chung
Tong, Peter C.Y.
Chan, Juliana C.N.
author_facet Yang, Xilin
Ko, Gary T.C.
So, Wing Yee
Ma, Ronald C.W.
Yu, Linda W.L.
Kong, Alice P.S.
Zhao, Hailu
Chow, Chun-Chung
Tong, Peter C.Y.
Chan, Juliana C.N.
author_sort Yang, Xilin
collection PubMed
description OBJECTIVE: Insulin has mitogenic effects, although hyperglycemia may be a risk factor for cancer in type 2 diabetes. It remains uncertain whether use of insulin increases cancer risk because of its effect on cell growth and proliferation or decreases cancer risk because of its glucose-lowering effect. RESEARCH DESIGN AND METHODS: A 1:2-matched new insulin user cohort on age (±3 years), smoking status, and likelihood of initiating insulin therapy (±0.05) was selected from a cohort of 4,623 Chinese patients with type 2 diabetes, free of cancer, and naive to insulin at enrollment. Stratified Cox regression analysis on the matched pairs was used to obtain hazard ratios (HRs) of insulin therapy and A1C for cancer risk. A structured adjustment scheme was used to adjust for covariates. RESULTS: Of 973 new insulin users, 971 had matched nonusers (n = 1935). The cancer incidence in insulin nonusers was much higher than that in insulin users (49.2 vs. 10.2, per 1,000 person-years, P < 0.0001). After further adjustment for all other covariates with a P value less than 0.3 and nonlinear associations with cancer, A1C was associated with an increased cancer risk (HR per percentage 1.26, 95% CI 1.03–1.55), whereas use of insulin was associated with a decreased cancer risk (HR of insulin users vs. nonusers: 0.17, 0.09–0.32). Consistent results were found in analyses including all 973 insulin users and 3,650 nonusers. CONCLUSIONS: In Chinese patients with type 2 diabetes, hyperglycemia predicts cancer, whereas insulin usage was associated with a reduced cancer risk.
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spelling pubmed-28579062011-05-01 Associations of Hyperglycemia and Insulin Usage With the Risk of Cancer in Type 2 Diabetes: The Hong Kong Diabetes Registry Yang, Xilin Ko, Gary T.C. So, Wing Yee Ma, Ronald C.W. Yu, Linda W.L. Kong, Alice P.S. Zhao, Hailu Chow, Chun-Chung Tong, Peter C.Y. Chan, Juliana C.N. Diabetes Original Article OBJECTIVE: Insulin has mitogenic effects, although hyperglycemia may be a risk factor for cancer in type 2 diabetes. It remains uncertain whether use of insulin increases cancer risk because of its effect on cell growth and proliferation or decreases cancer risk because of its glucose-lowering effect. RESEARCH DESIGN AND METHODS: A 1:2-matched new insulin user cohort on age (±3 years), smoking status, and likelihood of initiating insulin therapy (±0.05) was selected from a cohort of 4,623 Chinese patients with type 2 diabetes, free of cancer, and naive to insulin at enrollment. Stratified Cox regression analysis on the matched pairs was used to obtain hazard ratios (HRs) of insulin therapy and A1C for cancer risk. A structured adjustment scheme was used to adjust for covariates. RESULTS: Of 973 new insulin users, 971 had matched nonusers (n = 1935). The cancer incidence in insulin nonusers was much higher than that in insulin users (49.2 vs. 10.2, per 1,000 person-years, P < 0.0001). After further adjustment for all other covariates with a P value less than 0.3 and nonlinear associations with cancer, A1C was associated with an increased cancer risk (HR per percentage 1.26, 95% CI 1.03–1.55), whereas use of insulin was associated with a decreased cancer risk (HR of insulin users vs. nonusers: 0.17, 0.09–0.32). Consistent results were found in analyses including all 973 insulin users and 3,650 nonusers. CONCLUSIONS: In Chinese patients with type 2 diabetes, hyperglycemia predicts cancer, whereas insulin usage was associated with a reduced cancer risk. American Diabetes Association 2010-05 2010-02-25 /pmc/articles/PMC2857906/ /pubmed/20185812 http://dx.doi.org/10.2337/db09-1371 Text en © 2010 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Article
Yang, Xilin
Ko, Gary T.C.
So, Wing Yee
Ma, Ronald C.W.
Yu, Linda W.L.
Kong, Alice P.S.
Zhao, Hailu
Chow, Chun-Chung
Tong, Peter C.Y.
Chan, Juliana C.N.
Associations of Hyperglycemia and Insulin Usage With the Risk of Cancer in Type 2 Diabetes: The Hong Kong Diabetes Registry
title Associations of Hyperglycemia and Insulin Usage With the Risk of Cancer in Type 2 Diabetes: The Hong Kong Diabetes Registry
title_full Associations of Hyperglycemia and Insulin Usage With the Risk of Cancer in Type 2 Diabetes: The Hong Kong Diabetes Registry
title_fullStr Associations of Hyperglycemia and Insulin Usage With the Risk of Cancer in Type 2 Diabetes: The Hong Kong Diabetes Registry
title_full_unstemmed Associations of Hyperglycemia and Insulin Usage With the Risk of Cancer in Type 2 Diabetes: The Hong Kong Diabetes Registry
title_short Associations of Hyperglycemia and Insulin Usage With the Risk of Cancer in Type 2 Diabetes: The Hong Kong Diabetes Registry
title_sort associations of hyperglycemia and insulin usage with the risk of cancer in type 2 diabetes: the hong kong diabetes registry
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2857906/
https://www.ncbi.nlm.nih.gov/pubmed/20185812
http://dx.doi.org/10.2337/db09-1371
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