The association between fasting blood glucose and the risk of primary liver cancer in Chinese males: a population-based prospective study

BACKGROUND: To investigate the association between fasting blood glucose (FBG) levels and the risk of incident primary liver cancer (PLC) in Chinese males, a large prospective cohort was performed in the current study. METHODS: A total of 109 169 males participating in the routine checkups every two years were recruited in the Kailuan male cohort study since May 2006. Cox proportional hazards regression models and restricted cubic spline (RCS) were used to evaluate the association between levels of baseline FBG and the risk of incident PLC. RESULTS: Compared to the males with normal FBG (3.9⩽FBG<6.1 mmol l(−1)), the males with impaired fasting glucose (IFG: 6.1⩽FBG<7.0 mmol l(−1)) and diabetes mellitus (DM: FBG ⩾7.0 mmol l(−1)) had a 60% (95% CI: 1.09–2.35) and a 58% (95% CI: 1.07–2.34) higher risk of incident PLC, respectively. Subgroup analysis found that IFG increased the risk of PLC among the non-smoker (HR=1.73, 95% CI: 1.01–2.98) and current alcohol drinker (HR=1.80, 95% CI: 1.03–3.16). While DM increased the risk of PLC especially among the males with normal BMI (<25 kg m(−2)) (HR=1.76, 95% CI: 1.05–2.94) and the HBV negativity (HR=1.89, 95% CI: 1.16–3.09), RCS analysis showed a positive non-linearly association between the FBG levels and the risk of PLC (p-overall=0.041, p-non-linear=0.049). CONCLUSIONS: Increased FBG may be an important and potentially modifiable exposure that could have key scientific and clinical importance for preventing PLC development.