警惕：糖尿病增加头颈部癌风险
作者：admin 时间：2014-07-29 点击数：
2014年7月28日讯 /生物谷BIOON/--根据在JAMA Otolaryngology发表的一篇文章：糖尿病患者患头颈部癌（HNC）的风险比无糖尿病者高出近50％，而40岁到65岁的糖尿病患者这一风险相对更高。
台湾Tainan University of TechnologyKuo-Shu Tseng博士等和同事进行回顾性队列研究，比较89,089例新诊断为糖尿病患者和与糖尿病患者相匹配的年龄，性别，合并症的对照者的记录。
研究人员发现糖尿病组患头颈部癌症的发病率为对照组的1.47倍。糖尿病组之间癌症诊断平均年龄是55.52岁，指示日(index date) 和癌症诊断之间的平均间隔4.48年。
在糖尿病人群中，年龄在40岁至65岁的个体患头颈部癌症的风险显著较高，而男性的风险高于女性。
研究人员在调整了年龄，性别，合并症，地理分布，以及每月的收入，合并如肥胖，高血压，冠状动脉疾病，慢性肾脏疾病，和慢性阻塞性肺病等疾病后，采用Cox比例风险回归分析计算头颈部肿瘤的风险比。
与对照组相比，糖尿病组患癌风险高出近50％。在糖尿病组，头颈部癌症最常见的部位是口腔，另一个最普遍的癌症部位为鼻咽。
糖尿病增加头颈部肿瘤风险的可能机制
研究人员写道，糖尿病和头颈部癌之间的联系可能的机制包括：共享遗传危险因素;先天的表观遗传修饰或后天基因突变;长期暴露在高胰岛素血症，从而导致乳腺癌;暴露于高浓度的胰岛素和胰岛素样生长因子，它可以增加细胞增殖;和伴随糖尿病的代谢功能障碍。
这项研究的一个限制是，头颈部癌症的几个可疑危险因素，如病人的饮酒情况，吸烟和体力活动没有在数据库中，没有相关数据可用。（生物谷Bioon.com）
Risk of Head and Neck Cancer in Patients With Diabetes Mellitus
Kuo-Shu Tseng, PhD; et al.
Importance An increasing body of evidence suggests that certain types of cancers are more common in people with diabetes mellitus (DM). However, the risk of head and neck cancer (HNC) in patients with DM has seldom been explored.
Objective To examine the risk of HNC in patients with DM.
Design, Setting, and Participants In this retrospective cohort study using Taiwan’s Longitudinal Health Insurance Research Database, we compared 89?089 patients newly diagnosed as having DM and controls without DM-related medical claims matched for comorbidities (obesity, coronary artery disease, hyperlipidemia, and hypertension), sex, and age. Patients were assessed from the index date until the end of follow-up on December 31, 2011, or until the patient was censored because of death.
Main Outcomes and Measures The incidence of HNC at the end of 2011.
Results The incidence of HNC was 1.47 times higher in patients newly diagnosed as having DM than was the risk of a first malignant tumor in the control group (adjusted hazard ratio [AHR],?1.48; 95% CI,?1.31-1.67). The risks of oral cancer (AHR,?1.74; 95% CI,?1.47-2.06), oropharyngeal cancer (AHR,?1.53; 95% CI,?1.01-2.31), and nasopharyngeal carcinoma (AHR,?1.40; 95% CI,?1.03-1.89) were significantly higher in patients with DM than in controls.
Conclusions and Relevance Diabetes is associated with an increased risk of developing HNC. The risks of developing oral cavity cancer, oropharyngeal cancer, and nasopharyngeal carcinoma were significantly higher in patients with DM.
