Body mass index and cancer risk in patients with type 2 diabetes: a dose–response meta-analysis of cohort studies

Abstract

Although obesity has been associated with an increased cancer risk in the general population, the association in patients with type 2 diabetes (T2D) remains controversial. We conducted a dose–response meta-analysis of cohort studies of body mass index (BMI) and the risk of total and site-specific cancers in patients with T2D. A systematic literature search was conducted in PubMed, Scopus, and Medline until September 2020 for cohort studies on the association between BMI and cancer risk in patients with T2D. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random effects models. Ten prospective and three retrospective cohort studies (3,345,031 participants and 37,412 cases) were included in the meta-analysis. Each 5-unit increase in BMI (kg/m2) was associated with a 6% higher risk of total cancer (RR: 1.06, 95% CI 1.01, 1.10; I2 = 55.4%, n = 6), and with a 12% increased risk in the analysis of breast cancer (RR: 1.12, 95% CI 1.05, 1.20; I2 = 0%, n = 3). The pooled RRs showed no association with prostate cancer (RR: 1.02, 95% CI 0.92, 1.13; I2 = 64.6%, n = 4), pancreatic cancer (RR: 0.97, 95% CI 0.84, 1.11; I2 = 71%, n = 3), and colorectal cancer (RR: 1.05, 95% CI 0.98, 1.13; I2 = 65.9%, n = 2). There was no indication of nonlinearity for total cancer (Pnon-linearity = 0.99), however, there was evidence of a nonlinear association between BMI and breast cancer (Pnon-linearity = 0.004) with steeper increases in risk from a BMI around 35 and above respectively. Higher BMI was associated with a higher risk of total, and breast cancer but not with risk of other cancers, in patients with T2D, however, further studies are needed before firm conclusions can be drawn.

Body mass index and cancer risk among adults with and without cardiometabolic diseases: evidence from the EPIC and UK Biobank prospective cohort studies

“…Results did not materially differ between men and women (Additional File 1: Figures S5 and S6, Tables S3 and S4) except those for CVD, where we observed a stronger association between BMI-and obesity-related cancer risk among women than men (summary HR women: 1.22, 95% CI: 1.13-1.31; summary HR men: 1.07, 95% CI: 0.96-1. 19).…”

“…Prior studies focused on the BMI-cancer association in the general population, but little attention has been given to the co-occurrence of CMD [16][17][18]. In a 2021 metaanalysis of six cohort studies in patients with T2D, a higher BMI was associated with an increased risk of total cancer and breast cancer, a suggestive increased risk of colorectal cancer, but not with the risk of cancers of the prostate and pancreas [19]. Similar studies investigating BMI-cancer associations among population groups with CVD are largely lacking.…”

The Prevalence of Cancer in Indonesia: An Ecological Analysis

“…In diabetes and cancer, several previous studiesshow that people with diabetes have an increased risk of developing cancer. Also, in the study, the conclusion was there is a slight increase in the risk of developing breast cancer among women with type 2 diabetes 18,19 .…”

¿Podría ser la diabetes factor de riesgo para cáncer de pene?: a propósito de un caso

“…Otro factor es la fimosis, pudiendo ser de etiología primaria o secundaria; esta última puede ser, además, consecuencia de liquen escleroso, diabetes u obesidad (10) . Según Barnes et al, el riesgo de cáncer de pene invasivo se incrementa con el sobrepeso (OR = 2,64) y con la obesidad (OR = 3,24) (11) , lo cual podría estar relacionado con mecanismos secundarios a un autoexamen e higiene genital deficiente, pene enterrado con acumulación de esmegma y fimosis funcional (11) . El caso que se reporta no presento obesidad, ni sobrepeso.…”