Long-term patterns of fasting blood glucose levels and pancreatic cancer incidence

Na Na Keum, Kyoung Hwa Ha, Ying Bao, Moon Jae Chung, HyeonChang Kim, Edward L. Giovannucci

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Whether type 2 diabetes is cause or consequence, or both, of pancreatic cancer (PaC) remains unresolved. Leveraging repeated measurements of fasting blood glucose (FBG), we examined the temporal relationship between hyperglycemia and PaC incidence. Methods: We conducted a nested case–control study of 278 cases and 826 matched-controls from the Korean National Health Insurance Service-Health Screening Cohort. Over 11 years before index date (date of PaC diagnosis for cases), all participants had at least one FBG measurement in each of the three time windows: − 11 to − 8, − 7 to − 4, and − 3 to 0 years. Using conditional logistic regression, we estimated odds ratios(ORs) of PaC and 95% confidence intervals (CIs) for hyperglycemia in the overall period and at each interval; for major long-term patterns of FBG across the three intervals (recent-onset, medium-term, and long-standing hyperglycemia). Results: Higher FBG over the past 11 years was associated with an increased odds of PaC (p trend  < .0001), with recent FBG more predictive of PaC than distant FBG. By FBG assessed in the − 3 to 0 interval, OR was 1.97 (95% CI 1.32–2.93) for 110–125 mg/dL and 3.17 (95% CI 2.09–4.80) for ≥ 126 mg/dL. By long-term patterns of FBG, compared to consistent normoglycemia, OR was 2.02 (95% CI 1.24–3.31) for long-standing hyperglycemia and 3.38 (95% CI 1.87–6.13) for recent-onset hyperglycemia. These associations were more pronounced among never-smokers than ever-smokers (p interaction =.06). Conclusion: Recent-onset hyperglycemia may be an early manifestation of undetected PaC, while long-lasting hyperglycemia may serve as a moderate etiologic factor for PaC.

Original languageEnglish
Pages (from-to)135-142
Number of pages8
JournalCancer Causes and Control
Volume29
Issue number1
DOIs
Publication statusPublished - 2018 Jan 1

Fingerprint

Pancreatic Neoplasms
Blood Glucose
Fasting
Hyperglycemia
Incidence
Confidence Intervals
Odds Ratio
National Health Programs
Type 2 Diabetes Mellitus
Logistic Models
Health

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Keum, Na Na ; Ha, Kyoung Hwa ; Bao, Ying ; Chung, Moon Jae ; Kim, HyeonChang ; Giovannucci, Edward L. / Long-term patterns of fasting blood glucose levels and pancreatic cancer incidence. In: Cancer Causes and Control. 2018 ; Vol. 29, No. 1. pp. 135-142.
@article{f03039b6a91047ba853b63048c0d56a7,
title = "Long-term patterns of fasting blood glucose levels and pancreatic cancer incidence",
abstract = "Background: Whether type 2 diabetes is cause or consequence, or both, of pancreatic cancer (PaC) remains unresolved. Leveraging repeated measurements of fasting blood glucose (FBG), we examined the temporal relationship between hyperglycemia and PaC incidence. Methods: We conducted a nested case–control study of 278 cases and 826 matched-controls from the Korean National Health Insurance Service-Health Screening Cohort. Over 11 years before index date (date of PaC diagnosis for cases), all participants had at least one FBG measurement in each of the three time windows: − 11 to − 8, − 7 to − 4, and − 3 to 0 years. Using conditional logistic regression, we estimated odds ratios(ORs) of PaC and 95{\%} confidence intervals (CIs) for hyperglycemia in the overall period and at each interval; for major long-term patterns of FBG across the three intervals (recent-onset, medium-term, and long-standing hyperglycemia). Results: Higher FBG over the past 11 years was associated with an increased odds of PaC (p trend  < .0001), with recent FBG more predictive of PaC than distant FBG. By FBG assessed in the − 3 to 0 interval, OR was 1.97 (95{\%} CI 1.32–2.93) for 110–125 mg/dL and 3.17 (95{\%} CI 2.09–4.80) for ≥ 126 mg/dL. By long-term patterns of FBG, compared to consistent normoglycemia, OR was 2.02 (95{\%} CI 1.24–3.31) for long-standing hyperglycemia and 3.38 (95{\%} CI 1.87–6.13) for recent-onset hyperglycemia. These associations were more pronounced among never-smokers than ever-smokers (p interaction =.06). Conclusion: Recent-onset hyperglycemia may be an early manifestation of undetected PaC, while long-lasting hyperglycemia may serve as a moderate etiologic factor for PaC.",
author = "Keum, {Na Na} and Ha, {Kyoung Hwa} and Ying Bao and Chung, {Moon Jae} and HyeonChang Kim and Giovannucci, {Edward L.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s10552-017-0988-6",
language = "English",
volume = "29",
pages = "135--142",
journal = "Cancer Causes and Control",
issn = "0957-5243",
publisher = "Springer Netherlands",
number = "1",

}

Long-term patterns of fasting blood glucose levels and pancreatic cancer incidence. / Keum, Na Na; Ha, Kyoung Hwa; Bao, Ying; Chung, Moon Jae; Kim, HyeonChang; Giovannucci, Edward L.

In: Cancer Causes and Control, Vol. 29, No. 1, 01.01.2018, p. 135-142.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term patterns of fasting blood glucose levels and pancreatic cancer incidence

AU - Keum, Na Na

AU - Ha, Kyoung Hwa

AU - Bao, Ying

AU - Chung, Moon Jae

AU - Kim, HyeonChang

AU - Giovannucci, Edward L.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Whether type 2 diabetes is cause or consequence, or both, of pancreatic cancer (PaC) remains unresolved. Leveraging repeated measurements of fasting blood glucose (FBG), we examined the temporal relationship between hyperglycemia and PaC incidence. Methods: We conducted a nested case–control study of 278 cases and 826 matched-controls from the Korean National Health Insurance Service-Health Screening Cohort. Over 11 years before index date (date of PaC diagnosis for cases), all participants had at least one FBG measurement in each of the three time windows: − 11 to − 8, − 7 to − 4, and − 3 to 0 years. Using conditional logistic regression, we estimated odds ratios(ORs) of PaC and 95% confidence intervals (CIs) for hyperglycemia in the overall period and at each interval; for major long-term patterns of FBG across the three intervals (recent-onset, medium-term, and long-standing hyperglycemia). Results: Higher FBG over the past 11 years was associated with an increased odds of PaC (p trend  < .0001), with recent FBG more predictive of PaC than distant FBG. By FBG assessed in the − 3 to 0 interval, OR was 1.97 (95% CI 1.32–2.93) for 110–125 mg/dL and 3.17 (95% CI 2.09–4.80) for ≥ 126 mg/dL. By long-term patterns of FBG, compared to consistent normoglycemia, OR was 2.02 (95% CI 1.24–3.31) for long-standing hyperglycemia and 3.38 (95% CI 1.87–6.13) for recent-onset hyperglycemia. These associations were more pronounced among never-smokers than ever-smokers (p interaction =.06). Conclusion: Recent-onset hyperglycemia may be an early manifestation of undetected PaC, while long-lasting hyperglycemia may serve as a moderate etiologic factor for PaC.

AB - Background: Whether type 2 diabetes is cause or consequence, or both, of pancreatic cancer (PaC) remains unresolved. Leveraging repeated measurements of fasting blood glucose (FBG), we examined the temporal relationship between hyperglycemia and PaC incidence. Methods: We conducted a nested case–control study of 278 cases and 826 matched-controls from the Korean National Health Insurance Service-Health Screening Cohort. Over 11 years before index date (date of PaC diagnosis for cases), all participants had at least one FBG measurement in each of the three time windows: − 11 to − 8, − 7 to − 4, and − 3 to 0 years. Using conditional logistic regression, we estimated odds ratios(ORs) of PaC and 95% confidence intervals (CIs) for hyperglycemia in the overall period and at each interval; for major long-term patterns of FBG across the three intervals (recent-onset, medium-term, and long-standing hyperglycemia). Results: Higher FBG over the past 11 years was associated with an increased odds of PaC (p trend  < .0001), with recent FBG more predictive of PaC than distant FBG. By FBG assessed in the − 3 to 0 interval, OR was 1.97 (95% CI 1.32–2.93) for 110–125 mg/dL and 3.17 (95% CI 2.09–4.80) for ≥ 126 mg/dL. By long-term patterns of FBG, compared to consistent normoglycemia, OR was 2.02 (95% CI 1.24–3.31) for long-standing hyperglycemia and 3.38 (95% CI 1.87–6.13) for recent-onset hyperglycemia. These associations were more pronounced among never-smokers than ever-smokers (p interaction =.06). Conclusion: Recent-onset hyperglycemia may be an early manifestation of undetected PaC, while long-lasting hyperglycemia may serve as a moderate etiologic factor for PaC.

UR - http://www.scopus.com/inward/record.url?scp=85035804182&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85035804182&partnerID=8YFLogxK

U2 - 10.1007/s10552-017-0988-6

DO - 10.1007/s10552-017-0988-6

M3 - Article

C2 - 29197995

AN - SCOPUS:85035804182

VL - 29

SP - 135

EP - 142

JO - Cancer Causes and Control

JF - Cancer Causes and Control

SN - 0957-5243

IS - 1

ER -