The association between fasting blood glucose trajectory and cancer risk in Chinese population without diabetes

Feng, Xiaoshuang; Wang, Gang; Lyu, Zhangyan; Chen, Shuohua; Wei, Luopei; Li, Xin; Wen, Yan; Chen, Yuheng; Xie, Shuanghua; Cui, Hong; Chen, Hongda; Jiang, Li; Lin, Chunqing; Ren, Jiansong; Shi, Jufang; Wu, Shouling; Dai, Min; Ni, Li; He, Jie

doi:10.1002/ijc.32858

Cited by 9 publications

(16 citation statements)

References 32 publications

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“…36 A Chinese study performed trajectory analysis using longitudinal FBG data and found that the risk of GI cancer was significantly higher in the group with persistent IFG. 37 These findings support the proposal that both the extent and duration of hyperglycemia are essential factors for cancer development. In our study, more than half of the study population had changes in their glycemic status over 4 years.…”

Section: Discussionsupporting

confidence: 75%

Cumulative exposure to impaired fasting glucose and gastrointestinal cancer risk: A nationwide cohort study

Ahn,

Kim,

Park

et al. 2024

Cancer

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BackgroundImpaired fasting glucose (IFG) is associated with the risk of various cancers, but the cumulative effect of IFG on gastrointestinal cancer risk remains unclear. This study evaluated the association between the cumulative exposure to IFG and gastrointestinal cancer risk.MethodsThe authors extracted data from the Korean National Health Insurance Service and health examination data sets. Among individuals ≥40 years old who were free of diabetes or cancer, 1,430,054 who underwent national health examinations over 4 consecutive years from 2009 to 2012 were selected and followed up until gastrointestinal cancer diagnosis, death, or December 31, 2019. The IFG exposure score (range, 0–4) was based on the number of IFG diagnoses over 4 years.ResultsThe median follow‐up duration was 6.4 years. Consistent normoglycemia for 4 years was found in 44.3% of the population, whereas 5.0% had persistent IFG and 50.7% had intermittent IFG. Compared to the group with an IFG exposure score of 0, groups with IFG exposure scores of 1, 2, 3, and 4 had a 5%, 8%, 9%, and 12% increased risk of gastrointestinal cancer, respectively (score 1: adjusted hazard ratio [aHR], 1.05; 95% confidence interval [CI], 1.01–1.08; score 2: aHR, 1.08; 95% CI, 1.04–1.12; score 3: aHR, 1.09; 95% CI, 1.05–1.14; score 4: aHR, 1.12; 95% CI, 1.06–1.19). Persistent IFG exposure was also associated with higher risks of individual cancer types (colorectum, stomach, pancreas, biliary tract, and esophagus).ConclusionsCumulative exposure to IFG is associated with an increased risk of developing gastrointestinal cancer, in a dose‐dependent manner.Plain Language Summary Hyperglycemia, including both diabetes and prediabetes, has been associated with an increased risk of various cancers. However, the cumulative effect of impaired fasting glucose on the risk of developing gastrointestinal cancer remains unclear. A frequent diagnosis of impaired fasting glucose was dose‐dependently associated with a higher risk of developing overall gastrointestinal cancer. Furthermore, risks of individual cancer types increased with persistent impaired fasting glucose. Early detection of hyperglycemia and strict glycemic control can lower the risk of gastrointestinal cancer by reducing hyperglycemic burden. Additionally, for some individuals, lifestyle changes such as managing metabolic syndrome or abstaining from alcohol may also be helpful.

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Section: Discussionsupporting

confidence: 75%

Cumulative exposure to impaired fasting glucose and gastrointestinal cancer risk: A nationwide cohort study

Ahn,

Kim,

Park

et al. 2024

Cancer

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“…A previous study suggested an association between diabetes and risk of gastric cancer only at least 5 years after the diabetes diagnosis [ 7 ]. Another study found that only long-lastingly elevated serum glucose levels (but not other trajectory patterns) were associated with an increased risk of gastrointestinal cancer (HR 1.66, 95% CI 1.22–2.26) [ 45 ]. Another potential link between high HbA1c levels and gastric carcinogenesis might be the treatment for long-term poor glycaemic control.…”

Section: Discussionmentioning

confidence: 99%

Haemoglobin A1c and serum glucose levels and risk of gastric cancer: a systematic review and meta-analysis

et al. 2022

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Background This systematic review and meta-analysis examined associations between serum levels of haemoglobin A1c (HbA1c) and glucose and the risk of gastric cancer. Methods MEDLINE, Embase, and Cochrane Library were searched for studies examining associations between serum levels of HbA1c or glucose and the risk of gastric cancer. Inclusion of studies, quality assessment, and data extraction were conducted independently by two authors. Pooled hazard ratios (HR) with 95% confidence intervals (CI) were synthesised using random-effects models. Cochran’s Q test and I2 statistic were used to assess heterogeneity. Results Among 3473 identified studies, 12 were included. Of these, 5 studies examined HbA1c levels and 7 studies examined serum glucose levels. Serum HbA1c levels >6% were associated with an increased risk of gastric cancer (HR 1.36, 95% CI 1.06–1.74). When compared with the lowest glucose categories, the highest glucose categories were associated with a borderline increased risk of gastric cancer (HR 1.11, 95% CI 0.98–1.26). In subgroup analyses, studies that adjusted for Helicobacter pylori infection indicated stronger associations between elevated HbA1c levels and gastric cancer (HR 2.08, 95% CI 1.46–2.98) than those without such adjustment (HR 1.10, 95% CI 0.91–1.32). Conclusions Long-standing poor glycaemic control may increase the risk of gastric cancer. Registration number PROSPERO CRD42020157453.

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“…Although many patients have multiple episodes of abnormal FBG during hospitalization, it remains unclear whether a patient should be diagnosed with type 2 diabetes, considering the possibility of stress hyperglycemia and the effect of medications on blood glucose. In a prospective cohort study, discrete FBG trajectories were significantly associated with subsequent risk of myocardial infarction and cancer in individuals without diabetes ( 24 , 25 ). In addition to diabetes, changes in FBG may also play a key role in the development of other diseases.…”

Section: Discussionmentioning

confidence: 99%

Association Between Longitudinal Change in Abnormal Fasting Blood Glucose Levels and Outcome of COVID-19 Patients Without Previous Diagnosis of Diabetes

et al. 2021

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This retrospective study examined changes in fasting blood glucose (FBG) levels during hospitalization and their effect on risk of death for Coronavirus disease 2019 (COVID-19) patients without previously diagnosed diabetes. A model with low- and high-stable pattern trajectories was established based on a longitudinal change in FBG levels. We analyzed FBG trajectory-associated clinical features and risk factors for death due to COVID-19. Of the 230 enrolled patients, 44 died and 87.83% had a low-stable pattern (average FBG range: 6.63–7.54 mmol/L), and 12.17% had a high-stable pattern (average FBG range: 12.59–14.02 mmol/L). There were statistical differences in laboratory findings and case fatality between the two FBG patterns. Multivariable logistic regression analysis showed that increased neutrophil count (odds ratio [OR], 25.43; 95% confidence interval [CI]: 2.07, 313.03), elevated direct bilirubin (OR, 5.80; 95%CI: 1.72, 19.58), elevated creatinine (OR, 26.69; 95% CI: 5.82, 122.29), lymphopenia (OR, 8.07; 95% CI: 2.70, 24.14), and high-stable FBG pattern (OR, 8.79; 95% CI: 2.39, 32.29) were independent risk factors for higher case fatality in patients with COVID-19 and hyperglycemia but no history of diabetes. FBG trajectories were significantly associated with death risk in patients with COVID-19 and no diabetes.

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The association between fasting blood glucose trajectory and cancer risk in Chinese population without diabetes

Cited by 9 publications

References 32 publications

Cumulative exposure to impaired fasting glucose and gastrointestinal cancer risk: A nationwide cohort study

Cumulative exposure to impaired fasting glucose and gastrointestinal cancer risk: A nationwide cohort study

Haemoglobin A1c and serum glucose levels and risk of gastric cancer: a systematic review and meta-analysis

Association Between Longitudinal Change in Abnormal Fasting Blood Glucose Levels and Outcome of COVID-19 Patients Without Previous Diagnosis of Diabetes

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