| アブストラクト | AIMS: We evaluated the relationship between body mass index (BMI) and cancer mortality in incident type 2 diabetes. METHODS: We used the Clinical Practice Research Datalink GOLD (1998-2015), linked with the Office of National Statistics mortalities, and derived an incident type 2 diabetes cohort (N = 176 886; aged 30-85 years). We determined BMI +/-12 months diabetes diagnosis. The primary outcome was cancer mortality, categorized into deaths from obesity-related cancers (ORCs) and non-ORCs. Secondary outcomes were site-specific cancer mortality and main causes of deaths [cancer, cardiovascular disease (CVD), non-cancer non-CVD]. We developed gender-specific Cox models and expressed risk as hazard ratios and 95% confidence intervals, stratified by smoking status. RESULTS: With 886 850 person-years follow-up, 7593 cancer deaths occurred. Among women who never smoked, there were positive associations between BMI and deaths from endometrial (hazard ratios per 5 kg/m(2) : 1.43; 95% confidence interval 1.26-1.61). Among men, associations between BMI and ORC mortality were inverse but attenuated towards null among never smokers and excluding deaths in the first 2 years. In men, the proportion of CVD deaths increased from 36.8% in BMI category 22.5 to 24.9 kg/m(2) to 43.6% in BMI category >/=40 kg/m(2) (p < .001). CONCLUSIONS: We found some relationships between BMI and cancer mortality in patients with type 2 diabetes, but interpretations need to account for smoking status, reverse causality and deaths from CVD. |
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| 投稿者 | Alam, Nasra N; Wright, Alison K; Rutter, Martin K; Buchan, Iain; Ashcroft, Darren M; Sperrin, Matthew; Renehan, Andrew G |
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| 組織名 | Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology,;Medicine and Health, University of Manchester, Manchester, UK.;Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and;Optometry, School of Health Sciences, University of Manchester, Manchester;Academic Health Sciences Centre, Manchester, UK.;Division of Diabetes, Endocrinology and Gastroenterology, School of Medical;Sciences, University of Manchester, Manchester, UK.;Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS;Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK.;Department of Public Health and Policy, Institute of Population Health, Faculty;of Health and Life Sciences, University of Liverpool, Liverpool, UK.;Centre for Health Informatics, Division of Informatics, Imaging and Data Science,;School of Health Sciences, Faculty of Biology, Medicine and Health, University of;Manchester, Manchester, UK.;Manchester Cancer Research Centre, NIHR Manchester Biomedical Research Centre,;University of Manchester, Manchester, UK. |
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