White blood cell count and renin–angiotensin system inhibitors for the risk of cancer in type 2 diabetes
Autor: | Juliana C.N. Chan, Peter C.Y. Tong, Alice P.S. Kong, Gary T.C. Ko, Ronald C.W. Ma, Wing-Yee So, Hai-Lu Zhao, Xilin Yang, Gang Xu |
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Rok vydání: | 2010 |
Předmět: |
Male
Oncology medicine.medical_specialty Endocrinology Diabetes and Metabolism Angiotensin-Converting Enzyme Inhibitors Blood Pressure Type 2 diabetes Body Mass Index Leukocyte Count Patient Admission Endocrinology Risk Factors Neoplasms Internal medicine White blood cell Diabetes mellitus Renin–angiotensin system Leukocytes Internal Medicine medicine Humans Prospective cohort study Triglycerides Proportional Hazards Models business.industry Absolute risk reduction Type 2 Diabetes Mellitus Cancer General Medicine Middle Aged medicine.disease Cholesterol medicine.anatomical_structure Diabetes Mellitus Type 2 Hong Kong Female business |
Zdroj: | Diabetes Research and Clinical Practice. 87:117-125 |
ISSN: | 0168-8227 |
Popis: | Background High white blood cell (WBC) predicted cancer-associated mortality and renin–angiotensin system (RAS) inhibitors have immunomodulating effects. We hypothesize that RAS inhibitors may reduce cancer risk associated with high WBC in type 2 diabetes mellitus (T2DM). Methods A prospective cohort of 4570 Chinese T2DM patients, free of cancer at enrolment, were analyzed. Biological interaction between WBC groups and use of RAS inhibitors was estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). RERI>0, AP>0 or S>1 indicates biological interaction. Results During 4.89 years of follow-up, 205 (4.49%) patients developed cancer. WBC≥8.2×10 9 counts/L plus non-use of RAS inhibitors was associated with elevated cancer risks in multivariable models. The RERI and AP for interaction between WBC≥8.2×10 9 counts/L and non-use of RAS inhibitors were, respectively, 1.26 (95% CI: 0.22–2.31) and 0.50 (0.23–0.78). In patients with WBC≥8.2×10 9 counts/L, use of RAS inhibitors was associated with 64% (31–81%) cancer risk reduction in multivariable analysis. Conclusions In T2DM, increased WBC predicts cancer while use of RAS inhibitors may reduce cancer risks associated with high WBC count. |
Databáze: | OpenAIRE |
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