BMI and HbA1c are metabolic markers for pancreatic cancer: Matched case-control study using a UK primary care database.

Autor: Lemanska A; Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom., Price CA; Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom., Jeffreys N; Royal Surrey NHS Foundation Trust, Guildford, United Kingdom., Byford R; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom., Dambha-Miller H; Primary Care Research Centre, University of Southampton, Southampton, United Kingdom., Fan X; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom., Hinton W; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom., Otter S; Royal Surrey NHS Foundation Trust, Guildford, United Kingdom., Rice R; Barnardo's, Barkingside, Ilford, Essex, London, United Kingdom., Stunt A; Pancreatic Cancer Action, London, United Kingdom., Whyte MB; Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom., Faithfull S; Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom., de Lusignan S; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Oct 05; Vol. 17 (10), pp. e0275369. Date of Electronic Publication: 2022 Oct 05 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0275369
Abstrakt: Background: Weight loss, hyperglycaemia and diabetes are known features of pancreatic cancer. We quantified the timing and the amount of changes in body mass index (BMI) and glycated haemoglobin (HbA1c), and their association with pancreatic cancer from five years before diagnosis.
Methods: A matched case-control study was undertaken within 590 primary care practices in England, United Kingdom. 8,777 patients diagnosed with pancreatic cancer (cases) between 1st January 2007 and 31st August 2020 were matched to 34,979 controls by age, gender and diabetes. Longitudinal trends in BMI and HbA1c were visualised. Odds ratios adjusted for demographic and lifestyle factors (aOR) and 95% confidence intervals (CI) were calculated with conditional logistic regression. Subgroup analyses were undertaken according to the diabetes status.
Results: Changes in BMI and HbA1c observed for cases on longitudinal plots started one and two years (respectively) before diagnosis. In the year before diagnosis, a 1 kg/m2 decrease in BMI between cases and controls was associated with aOR for pancreatic cancer of 1.05 (95% CI 1.05 to 1.06), and a 1 mmol/mol increase in HbA1c was associated with aOR of 1.06 (1.06 to 1.07). ORs remained statistically significant (p < 0.001) for 2 years before pancreatic cancer diagnosis for BMI and 3 years for HbA1c. Subgroup analysis revealed that the decrease in BMI was associated with a higher pancreatic cancer risk for people with diabetes than for people without (aORs 1.08, 1.06 to 1.09 versus 1.04, 1.03 to 1.05), but the increase in HbA1c was associated with a higher risk for people without diabetes than for people with diabetes (aORs 1.09, 1.07 to 1.11 versus 1.04, 1.03 to 1.04).
Conclusions: The statistically significant changes in weight and glycaemic control started three years before pancreatic cancer diagnosis but varied according to the diabetes status. The information from this study could be used to detect pancreatic cancer earlier than is currently achieved. However, regular BMI and HbA1c measurements are required to facilitate future research and implementation in clinical practice.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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