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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

Grote, V. A.; Rohrmann, S.; Nieters, A.; Dossus, L.; Tjonneland, A.; Halkjaer, J.; Overvad, K.; Fagherazzi, G.; Boutron-Ruault, M. C. and Morois, S., et al. (2011) In Diabetologia 54(12). p.3037-3046
Abstract
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... (More)
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. (Less)
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keywords
C-peptide, HbA(1c), Cohort study, Diabetes, EPIC, Pancreatic cancer
in
Diabetologia
volume
54
issue
12
pages
3037 - 3046
publisher
Springer Verlag
external identifiers
  • wos:000297740000010
  • scopus:82455192294
ISSN
1432-0428
DOI
10.1007/s00125-011-2316-0
language
English
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yes
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58687f17-3ddf-48fa-a594-f95869ede9c7 (old id 2291931)
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2012-01-11 15:58:36
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2017-08-13 03:20:24
@article{58687f17-3ddf-48fa-a594-f95869ede9c7,
  abstract     = {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 [&gt;= 6.5%, 48 mmol/mol] vs lowest [&lt;= 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.},
  author       = {Grote, V. A. and Rohrmann, S. and Nieters, A. and Dossus, L. and Tjonneland, A. and Halkjaer, J. and Overvad, K. and Fagherazzi, G. and Boutron-Ruault, M. C. and Morois, S. and Teucher, B. and Becker, S. and Sluik, D. and Boeing, H. and Trichopoulou, A. and Lagiou, P. and Trichopoulos, D. and Palli, D. and Pala, V. and Tumino, R. and Vineis, P. and Panico, S. and Rodriguez, L. and Duell, E. J. and Molina-Montes, E. and Dorronsoro, M. and Huerta, J. M. and Ardanaz, E. and Jeurnink, S. M. and Beulens, J. W. J. and Peeters, P. H. M. and Sund, M. and Ye, W. and Lindkvist, B. and Johansen, Dorthe and Khaw, K. T. and Wareham, N. and Allen, N. and Crowe, F. and Jenab, M. and Romieu, I. and Michaud, D. S. and Riboli, E. and Romaguera, D. and Bueno-de-Mesquita, H. B. and Kaaks, R.},
  issn         = {1432-0428},
  keyword      = {C-peptide,HbA(1c),Cohort study,Diabetes,EPIC,Pancreatic cancer},
  language     = {eng},
  number       = {12},
  pages        = {3037--3046},
  publisher    = {Springer Verlag},
  series       = {Diabetologia},
  title        = {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},
  url          = {http://dx.doi.org/10.1007/s00125-011-2316-0},
  volume       = {54},
  year         = {2011},
}