TY - JOUR
TI - Diabetes mellitus, glycated haemoglobin and C-peptide levels in relation
to pancreatic cancer risk: a study within the European Prospective
Investigation into Cancer and Nutrition (EPIC) cohort
AU - Grote, V. A.
AU - Rohrmann, S.
AU - Nieters, A.
AU - Dossus, L. and
AU - Tjonneland, A.
AU - Halkjaer, J.
AU - Overvad, K.
AU - Fagherazzi, G. and
AU - Boutron-Ruault, M. C.
AU - Morois, S.
AU - Teucher, B.
AU - Becker, S. and
AU - Sluik, D.
AU - Boeing, H.
AU - Trichopoulou, A.
AU - Lagiou, P. and
AU - Trichopoulos, D.
AU - Palli, D.
AU - Pala, V.
AU - Tumino, R.
AU - Vineis,
AU - P.
AU - Panico, S.
AU - Rodriguez, L.
AU - Duell, E. J.
AU - Molina-Montes,
AU - E.
AU - Dorronsoro, M.
AU - Huerta, J. M.
AU - Ardanaz, E.
AU - Jeurnink, S.
AU - M.
AU - Beulens, J. W. J.
AU - Peeters, P. H. M.
AU - Sund, M.
AU - Ye, W.
AU - and Lindkvist, B.
AU - Johansen, D.
AU - Khaw, K. T.
AU - Wareham, N. and
AU - Allen, N.
AU - Crowe, F.
AU - Jenab, M.
AU - Romieu, I.
AU - Michaud, D. S.
AU - and Riboli, E.
AU - Romaguera, D.
AU - Bueno-de-Mesquita, H. B.
AU - Kaaks,
AU - R.
JO - Diabetologia
PY - 2011
VL - 54
TODO - 12
SP - 3037-3046
PB - Springer-Verlag
SN - 0012-186X, 1432-0428
TODO - 10.1007/s00125-011-2316-0
TODO - C-peptide; HbA(1c); Cohort study; Diabetes; EPIC; Pancreatic cancer
TODO - Aims/hypothesis There has been long-standing debate about whether
diabetes is a causal risk factor for pancreatic cancer or a consequence
of tumour development. Prospective epidemiological studies have shown
variable relationships between pancreatic cancer risk and blood markers
of glucose and insulin metabolism, overall and as a function of lag
times between marker measurements (blood donation) and date of tumour
diagnosis.
Methods Pre-diagnostic levels of HbA(1c) and C-peptide were measured for
466 participants with pancreatic cancer and 466 individually matched
controls within the European Prospective Investigation into Cancer and
Nutrition. Conditional logistic regression models were used to estimate
ORs for pancreatic cancer.
Results Pancreatic cancer risk gradually increased with increasing
pre-diagnostic HbA(1c) levels up to an OR of 2.42 (95% CI 1.33, 4.39
highest [>= 6.5%, 48 mmol/mol] vs lowest [<= 5.4%, 36 mmol/mol]
category), even for individuals with HbA(1c) levels within the
non-diabetic range. C-peptide levels showed no significant relationship
with pancreatic cancer risk, irrespective of fasting status. Analyses
showed no clear trends towards increasing hyperglycaemia (as marked by
HbA(1c) levels) or reduced pancreatic beta cell responsiveness (as
marked by C-peptide levels) with decreasing time intervals from blood
donation to cancer diagnosis.
Conclusions/interpretation Our data on HbA(1c) show that individuals who
develop exocrine pancreatic cancer tend to have moderate increases in
HbA(1c) levels, relatively independently of obesity and insulin
resistance-the classic and major risk factors for type 2 diabetes. While
there is no strong difference by lag time, more data are needed on this
in order to reach a firm conclusion.
ER -