Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies

Abstract

Objectives To summarise the evidence and evaluate the validity of the associations between type 2 diabetes and the risk of developing or dying from cancer.Design An umbrella review of the evidence across meta-analyses of observational studies of type 2 diabetes with risk of developing or dying from any cancer.Data sources PubMed, Embase, Cochrane database of systematic reviews, and manual screening of references.Eligibility criteria Meta-analyses or systematic reviews of observational studies in humans that examined the association between type 2 diabetes and risk of developing or dying from cancer.Results Eligible meta-analyses assessed associations between type 2 diabetes and risk of developing cancer in 20 sites and mortality for seven cancer sites. The summary random effects estimates were significant at P=0.05 in 20 meta-analyses (74%); and all reported increased risks of developing cancer for participants with versus without diabetes. Of the 27 meta-analyses, eventually only seven (26%) compiled evidence on more than 1000 cases, had significant summary associations at P≤0.001 for both random and fixed effects calculations, and had neither evidence of small study effects nor evidence for excess significance. Of those, only six (22%) did not have substantial heterogeneity (I 2 >75%), pertaining to associations between type 2 diabetes and risk of developing breast, cholangiocarcinoma (both intrahepatic and extrahepatic), colorectal, endometrial, and gallbladder cancer. The 95% prediction intervals excluded the null value for four of these associations (breast, intrahepatic cholangiocarcinoma, colorectal, and endometrial cancer).Conclusions Though type 2 diabetes has been extensively studied in relation to risk of developing cancer and cancer mortality and strong claims of significance exist for most of the studied associations, only a minority of these associations have robust supporting evidence without hints of bias.

Colorectalis daganatokban a 2-es típusú cukorbetegség és a thrombocytosis előfordulása, a túlélésre gyakorolt hatásuk, a primer tumor műtéti eltávolítása előtt és után

“…Számos elmélet született, hogy e megfigyelés hátterében különböző, a T2DM-et befolyásoló, illetve a betegség miatt kialakuló tényezők állhatnak, mint például a hyperglykaemia, az inzulinrezisztencia, a hyperinsulinaemia, a magasabb széruminzu-lin-szerű növekedési faktor-1 (IGF1) koncentrációja, a folyamatos gyulladásos állapotok miatti magasabb citokinkoncentrációk, az oxidatív stressz, a dyslipidaemia vagy a fokozott thrombocytaaktiváció [20][21][22][23][24][25]. A T2DM-betegek kezelése során alkalmazott különböző antidiabetikumok tumorokkal szembeni védő-vagy ép-pen azok növekedését serkentő hatása jelenleg is számos klinikai gyógyszervizsgálat tárgyát képezi [21].…”

Growth Hormone Replacement Therapy in Adult Growth Hormone Deficiency and Risk of Cancer: A Meta-Analysis

“…Statistical analysis was performed as previously described by Tsilid is et al [11]; all analyses were conducted using the fixed effects model. Methods of fixed effect meta-analysis were based on the assumption that a single common (or "fixed") effect underlies every study in the meta-analysis without any heterogeneity between studies.…”

Alteraciones en la exhibición de receptor de insulina en linfocitos tumorales humanos impuestas por la diabetes

“…La población obesa y la diabética presentan frecuencias aumentadas de cánceres específicos (Shikata, et al 2013, Tsilidis, et al 2015 representando una enorme carga social y económica dada su creciente prevalencia.…”