Type II diabetes mellitus is associated with a reduced risk of cholangiocarcinoma in patients with biliary tract diseases

Abstract

Ithas not yet been reported whether Type II diabetes mellitus (DM) is associated with an increased cholangiocarcinoma (CC) risk in patients with biliary tract diseases. We identified 123,050 patients concomitantly diagnosed with biliary tract diseases and DM between 1998 and 2010. The control cohort consisted of 122,721 individuals with biliary tract diseases but not DM. Both cohorts were followed-up until the end of 2010 to estimate the risk of CC. We also compared the risk of CC between DM and non-DM cohorts without biliary tract diseases. Overall, the incidence of CC was 21% lower among the DM patients than among the control patients (1.11 vs. 1.41 per 1,000 person-years). DM cohorts exhibited significantly reduced risks for both intrahepatic and extrahepatic CC. A multivariable Cox proportional hazards regression model was used, and the adjusted hazard ratio (HR) of CC was 0.74 (95% confidence interval [CI], 0.66-0.82) for the DM cohort in comparison with the control cohort. The age-specific data indicated that compared with the control patients, the adjusted HRs for the DM patients were significantly lower among patients 50-64 (adjusted HR 5 0.67; 95% CI 5 0.55-0.82) and 65-74 years old (adjusted HR 5 0.70; 95% CI, 0.59-0.84). Furthermore, DM was associated with a lower risk of CC among patients with biliary diseases, regardless of the presence of comorbidities and the status of cholecystectomy. In the patients without biliary tract diseases, DM is associated with significantly increased risk of CC (adjusted HR 5 1.58; 95% CI, 1.37-1.82).Cholangiocarcinoma (CC) is the most common biliary malignancy and the second most common hepatic malignancy after hepatocellular carcinoma, and accounts for 3% of all gastrointestinal tumors.

The association between non‐alcoholic steatohepatitis and intrahepatic cholangiocarcinoma: A hospital based case‐control study

“…Although previous studies have shown that DM is a risk factor for ICC , the prevalence of DM did not differ between the ICC group and the control group in the present study. However, almost all the patients in the control group had MLT from colorectal cancer, which has also been reported to be associated with DM .…”

Association of comorbidity between Opisthorchis viverrini infection and diabetes mellitus in the development of cholangiocarcinoma among a high-risk population, northeastern Thailand

“…One study in a non-endemic area for liver-fluke infection reported that DM may be a protective factor against CCA development in those with biliary tract diseases. However, DM was also associated with significantly increased risk of CCA in patients without these conditions [ 14 ]. This finding is consistent with another study in northeastern Thailand, which found that, before praziquantel (PQZ) treatment, O .…”

“…viverrini is not the only risk factor for CCA. Several other diseases have been linked with the condition, including diabetes mellitus (DM) [ 13 , 14 ]. Recent studies have reported that DM is a risk factor for both intrahepatic and extrahepatic subtypes of CCA [ 15 ]: patients with DM were 1.6 times more likely to be incident cases of CCA compared with those without DM [ 16 ].…”

Identification of prognostic factors for intrahepatic cholangiocarcinoma based on long non-coding RNAs-associated ceRNA network

“…As genes encoding proteins related to insulin receptor, IGF1R could stimulate renal cancer cells [28]. Type II diabetes mellitus could reduce the risk of cholangiocarcinoma in patients with biliary tract diseases [29].…”