文章：

糖化血红蛋白（HbA1c）水平升高与胰腺导管腺癌风险增加相关：一项英国生物银行队列研究

Elevated Glycated Haemoglobin (HbA1c) Is Associated with an Increased Risk of Pancreatic Ductal Adenocarcinoma: A UK Biobank Cohort Study

原文发布日期：13 August 2023

DOI: 10.3390/cancers15164078

类型: Article

开放获取: 是

英文摘要：

Background: The role of dysglycaemia as a risk marker for Pancreatic Ductal Adenocarcinoma (PDAC) is uncertain. We investigated the relationship between glycated haemoglobin (HbA1c) and incident PDAC using a retrospective cohort study within the UK Biobank. Methods: A study involving 499,804 participants from the UK Biobank study was undertaken. Participants were stratified by diabetes mellitus (DM) status, and then by HbA1c values < 42 mmol/mol, 42–47 mmol/mol, or ≥48 mmol/mol. Cox proportional hazard models were used to describe the association between HbA1c category (with time-varying interactions) and incident PDAC. Results: PDAC occurred in 1157 participants during 11.6 (10.9–12.3) years follow up [(median (interquartile range)]. In subjects without known DM at baseline, 12 months after recruitment, the adjusted hazard ratios (aHR, 95% CI) for incident PDAC for HbA1c 42–47 mmol/mol compared to HbA1c < 42 mmol/mol (reference group) was 2.10 (1.31–3.37,p= 0.002); and was 8.55 (4.58–15.99,p< 0.001) for HbA1c ≥ 48 mmol/mol. The association between baseline HbA1c and incident PDAC attenuated with increasing duration of time of follow-up to PDAC diagnosis. Conclusions: Dysglycaemia detected by elevated HbA1c is associated with an increased risk of PDAC. The strength of the association between elevated HbA1c and incident PDAC is inversely proportional to the time from detecting dysglycaemia but remains significant for at least 60 months following HbA1c testing.

摘要翻译： 

背景：血糖异常作为胰腺导管腺癌（PDAC）风险标志物的作用尚不明确。本研究利用英国生物银行（UK Biobank）的回顾性队列数据，探讨了糖化血红蛋白（HbA1c）与PDAC发病之间的关系。方法：研究纳入了英国生物银行中的499,804名参与者。根据糖尿病（DM）状态对参与者进行分层，再按HbA1c值分为<42 mmol/mol、42–47 mmol/mol或≥48 mmol/mol三组。采用Cox比例风险模型分析HbA1c类别（考虑时变交互作用）与PDAC发病的关联。结果：在11.6年（10.9–12.3年）的中位随访期间（四分位距），共有1157名参与者发生PDAC。在基线时无已知糖尿病的受试者中，入组12个月后，与HbA1c <42 mmol/mol组（参照组）相比，HbA1c为42–47 mmol/mol组的PDAC发病风险调整后风险比（aHR，95% CI）为2.10（1.31–3.37，p=0.002）；HbA1c ≥48 mmol/mol组的aHR为8.55（4.58–15.99，p<0.001）。基线HbA1c与PDAC发病的关联强度随随访至PDAC诊断时间的延长而减弱。结论：通过HbA1c升高检测到的血糖异常与PDAC风险增加相关。HbA1c升高与PDAC发病的关联强度与发现血糖异常后的时间呈反比，但在HbA1c检测后至少60个月内仍具有显著意义。

原文链接：

Elevated Glycated Haemoglobin (HbA1c) Is Associated with an Increased Risk of Pancreatic Ductal Adenocarcinoma: A UK Biobank Cohort Study