Fasting Plasma Glucose Variability and Gastric Cancer Risk in Individuals Without Diabetes Mellitus : A Nationwide Population-Based Cohort Study

INTRODUCTION: Long-term glycemic variability is associated with various adverse health outcomes in patients with diabetes mellitus (DM). However, the relationship between glycemic variability and gastric cancer remains unclear. We aimed to investigate the association between glycemic variability and gastric cancer incidence in individuals without DM.

METHODS: We used the Korean National Health Insurance Service data sets of claims and health checkups and included 202,562 individuals without DM. Fasting plasma glucose (FPG) variability was measured using the variability independent of the mean (VIM), coefficient of variation, SD, and average successive variability. The association between FPG variability and gastric cancer incidence was analyzed using Cox regression adjusting for age, sex, body mass index, smoking status, alcohol consumption, regular exercise, income level, family history of cancer, mean FPG level, and number/mean interval of FPG measurements.

RESULTS: In total, 1,920 patients developed gastric cancer (0.95%) within a median follow-up of 5.6 (5.3, 6.4) years. The fully adjusted hazard ratio and 95% confidence interval for gastric cancer were 1.26 and 1.18-1.34, respectively, in the highest quartile of FPG variability assessed by VIM compared with that in the lowest quartile. Similar results were obtained in the normal and impaired fasting glucose groups and when using the variability indexes, including coefficient of variation, SD, and average successive variability. There was a sequential increase in the incidence of gastric cancer according to the increase in the deciles of FPG variability (P for linear trend <0.001). A 1-SD increase in FPG variability assessed by VIM was significantly associated with a 10.0% increase in gastric cancer risk in the fully adjusted model.

DISCUSSION: In a DM-free population, high variability in visit-to-visit FPG levels was independently associated with an increased risk of gastric cancer.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:11

Enthalten in:

Clinical and translational gastroenterology - 11(2020), 9 vom: 01. Sept., Seite e00221

Sprache:

Englisch

Beteiligte Personen:

Hong, So-Hyeon [VerfasserIn]
Noh, Eunjin [VerfasserIn]
Kim, Jinsil [VerfasserIn]
Hwang, Soon Young [VerfasserIn]
Kim, Jun A [VerfasserIn]
Lee, You-Bin [VerfasserIn]
Roh, Eun [VerfasserIn]
Choi, Kyung Mook [VerfasserIn]
Baik, Sei Hyun [VerfasserIn]
Cho, Geum Joon [VerfasserIn]
Yoo, Hye Jin [VerfasserIn]

Links:

Volltext

Themen:

Blood Glucose
Journal Article
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 08.07.2021

Date Revised 05.10.2022

published: Print

Citation Status MEDLINE

doi:

10.14309/ctg.0000000000000221

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM314317694