Glycated hemoglobin A1c is superior to fasting plasma glucose as an independent risk factor for colorectal neoplasia

Abstract

HbA1c as compared with fasting plasma glucose is more strongly and independently associated with colorectal neoplasia. Further research is warranted to elucidate the value of HbA1c in stratifying risk of colorectal cancer.

Does cancer risk increase with HbA1c, independent of diabetes?

“…Hsu et al (2012) found an increase of OR=1.25 in colorectal neoplasia for each percentage increase in HbA 1c level for men and women ( P =0.02). HbA 1c was not statistically significantly associated with colorectal adenoma, distal colorectal adenoma or advanced adenoma in two studies (Wei et al , 2006; Yang et al , 2010).…”

The Relationship between Nonalcoholic Fatty Liver Disease and Colorectal Cancer: The Future Challenges and Outcomes of the Metabolic Syndrome

“…There is increasing evidence that abnormal glucose metabolism is associated with an increased risk of colorectal cancer [51, 52]. There is an extensive body of research examining the relationship between diabetes and colorectal cancer, and findings have so far varied, with relative risks of colorectal cancer ranging from 1.2 to 2.8 in prospective cohort studies [48].…”

“…Khaw et al examined the relationship between known diabetes and glycated haemoglobin (HbA1c) concentrations measured in 9,605 men and women and subsequent incident colorectal cancer after 6 years follow up in the European Prospective Investigation into Cancer-Norfolk Study [51, 52, 54]. Their main finding is that the risk of colorectal cancer increased after HbA1c concentrations above 7%.…”

“…Several studies have reported stronger associations between impaired glucose tolerance and cancer than diabetes with cancer [51]. Saydah et al reported a significant risk of colorectal cancer mortality with impaired glucose tolerance, but not diabetes (RR 1.87 versus 1.13) [53].…”

“…Saydah et al reported a significant risk of colorectal cancer mortality with impaired glucose tolerance, but not diabetes (RR 1.87 versus 1.13) [53]. Overall findings of diabetes association with colorectal cancer have not been entirely consistent [51]. Some have suggested that this may be due to the alternating course of diabetes, with insulin resistance initially associated with hyperinsulinaemia, and in latter stages it leads to hypoinsulinaemia secondary to B-cell failure.…”