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BMI and HbA1c as metabolic markers for pancreatic cancer

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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BMI and HbA1c as metabolic markers for pancreatic cancer

New-onset diabetes may indicate subclinical pancreatic cancer, and patients with new-onset diabetes may constitute a population in whom pancreatic cancer can be detected early (1)

  • been reported that the prevalence of diabetes and impaired glucose tolerance in pancreatic cancer cases is as high as 80% (1,2)
    • in the majority of cases, diabetes associated with pancreatic cancer is diagnosed fewer than 2 years prior to the cancer diagnosis or during the cancer course
    • among patients with early-stage pancreatic cancer, diabetes has developed more often in patients with carcinoma of the head of the pancreas than in those with carcinoma of the body and/or tail of the organ
      • the reasons why diabetes develops in patients with pancreatic cancer remains unclear
      • nearly half the patients with early stage, resectable tumors have diabetes (2)

A study by Lemanska et al showed that statistically significant changes in weight and glycaemic control started three years before pancreatic cancer diagnosis but varied according to the diabetes status:

  • odds ratios were adjusted for demographic and lifestyle factors (aOR)
  • in the year before diagnosis, a 1 kg/m2 decrease in BMI between cases and controls was associated with aOR for pancreatic cancer of 1.05 (95% CI 1.05 to 1.06), and a 1 mmol/mol increase in HbA1c was associated with aOR of 1.06 (1.06 to 1.07)
    • ORs remained statistically significant (p < 0.001) for 2 years before pancreatic cancer diagnosis for BMI and 3 years for HbA1c
    • subgroup analysis revealed that the decrease in BMI was associated with a higher pancreatic cancer risk for people with diabetes than for people without (aORs 1.08, 1.06 to 1.09 versus 1.04, 1.03 to 1.05), but the increase in HbA1c was associated with a higher risk for people without diabetes than for people with diabetes (aORs 1.09, 1.07 to 1.11 versus 1.04, 1.03 to 1.04)

Reference:


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