Longitudinal Changes in Fasting Blood Glucose and Cancer Risk in Chinese Population Without Diabetes


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Xiaoshuang Feng1,Gang Wang2,Zhangyan Lyu1,Shuohua Chen3,Luopei Wei1,Xin Li1,Yan Wen1,Yuheng Chen1,Shuanghua Xie1,Hong Cui1,Hongda Chen1,Jiang Li1,Chunqing Lin1,Jiansong Ren1,Jufang Shi1,Shouling Wu4,Min Dai1,Ni Li1,Jie He1
1National Cancer Center / National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College,2Kailuan general hospital,3Health department of Kailuan Group,4Health Department of Kailuan Group

Abstract

Background

To prospectively examine the association between changes in fasting blood glucose (FBG) over time and the risk of developing cancer with carefully controlling for BMI status in adults without diabetes.

Method

We enrolled 69 742 participants without diabetes from Kailuan cohort who participated in the examination in 2006, and at least one examination in 2008 and 2010. FBG trajectories (2006-2010) were identified by group-based trajectory modeling. 1364 cancer cases were accumulated between 2010 and 2015. We used Cox proportional hazards regression models to evaluate the association between FBG trajectory patterns and the risk of cancer. We further assessed the associations by initial body mass index (BMI) in 2006, status and percent changes in BMI during 2006-2010.

Results

The mean age of the population was 50±12, and 22% were women. We identified five FBG trajectories: low-increasing (6275), moderate-stable (44 120), moderate-increasing (10 149), elevated-decreasing (5244), and elevated-stable (3954). Relative to the moderate-stable group, the Hazard ratio (HR) for overall cancer was 1.26 (95% confidence interval (CI) 1.06-1.50) in the low-increasing group. Moreover, the HR for overall cancer was 1.26 (95% CI 1.02-1.56) among participants with initial BMI≥25 kg/m2 in the moderate-increasing group, 0.70 (95% CI 0.49-0.98) among participants with initial BMI<25 kg/m2 in the elevated-decreasing group, and 1.43 (95% CI 1.10-1.87) among participants with stable BMI (4.40% loss-5.15% gain) in the elevated-stable group. Furthermore, we found higher HRs for cancers of colorectum (HR=1.77, 95% CI 1.07-2.94) and liver (HR=1.84, 95% CI 1.03-3.29) in the elevated-stable group.

Conclusion

FBG trajectory was associated with overall cancer risk among participants without diabetes in the Kailuan cohort, and BMI may modify the associations, indicating that FBG surveillance combined with BMI over time could be used to identify individuals at high risk of developing cancer among the population without diabetes.