Document Detail


Serial glycosylated hemoglobin levels and risk of colorectal neoplasia among patients with type 2 diabetes mellitus.
MedLine Citation:
PMID:  20937982     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hyperglycemia may increase the risk of colorectal neoplasia by serving as an energy source for neoplastic growth. We sought to determine whether glycemic control measured by serial hemoglobin A1c (HbA1c) was associated with the risk of colorectal adenoma.
METHODS: Among a cohort of patients with type 2 diabetes mellitus who received health care within the Kaiser Permanente Northern California from 1994 to 2005, we conducted 2 case-control analyses. Cases had at least 1 colorectal adenoma identified at either colonoscopy (analysis 1) or sigmoidoscopy (analysis 2). Controls had no colorectal neoplasia identified at the corresponding endoscopic examination. Serial HbA1c levels between the cases and the controls were compared using a longitudinal model.
RESULTS: Case-control analysis 1 included 4,248 patients, of whom 1,296 (31%) had at least 1 adenoma. The adjusted mean HbA1c levels among those without any adenomas was 8.20% versus 8.26% among those with at least 1 adenoma, a difference of 0.06% (95% CI = -0.02 to 0.14, P = 0.16). Case-control analysis 2 included 9,813 patients, of whom 951 (10%) had at least 1 distal adenoma. The adjusted mean HbA1c levels among those without any distal adenomas was 8.32% versus 8.37% among those with at least 1 distal adenoma, a difference of 0.05% (95% CI = -00.04 to 0.14, P = 0.25). The results were similar for advanced adenomas.
CONCLUSIONS: Glycemic control was not associated with the risk of colorectal adenoma among diabetic persons.
IMPACT: These results would suggest that glycemic control is unlikely to confound the reported association between diabetes medications and the risk of colorectal cancer.
Authors:
Yu-Xiao Yang; Laurel A Habel; Angela M Capra; Ninah S Achacoso; Charles P Quesenberry; Assiamira Ferrara; Theodore R Levin; James D Lewis
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-10-11
Journal Detail:
Title:  Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology     Volume:  19     ISSN:  1538-7755     ISO Abbreviation:  Cancer Epidemiol. Biomarkers Prev.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-15     Completed Date:  2011-04-06     Revised Date:  2011-12-21    
Medline Journal Info:
Nlm Unique ID:  9200608     Medline TA:  Cancer Epidemiol Biomarkers Prev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3027-36     Citation Subset:  IM    
Copyright Information:
©2010 AACR.
Affiliation:
Department of Medicine, Division of Gastroenterology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 722 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA. yangy@mail.med.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Adenoma / blood*,  complications,  epidemiology*
Aged
Case-Control Studies
Colorectal Neoplasms / blood*,  complications,  epidemiology*
Diabetes Mellitus, Type 2 / blood,  complications*
Female
Hemoglobin A, Glycosylated / analysis*
Humans
Male
Middle Aged
Risk Factors
Grant Support
ID/Acronym/Agency:
CA102599/CA/NCI NIH HHS; R01 CA102599-03/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Hemoglobin A, Glycosylated

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