Metabolic dysfunction-associated profiles and subsequent site-specific risk of obesity-related cancers among Chinese patients with diabetes: a retrospective cohort study

• Published in: BMJ open 2024-04, Vol.14 (4), p.e082414
• Main Authors: Yau, Sarah Tsz Yui, Leung, Eman, Wong, Martin Chi Sang, Hung, Chi Tim, Chong, Ka Chun, Lee, Albert, Yeoh, Eng Kiong
• Format: Article
• Language: English
• Subjects: Bladder cancer; Body mass index; Cholesterol; Chronic illnesses; Cohort analysis; Colon; Demographics; Diabetes; diabetes & endocrinology; Diabetes Mellitus - epidemiology; Disease; Electronic health records; Epidemiology; Glucose; Hepatitis; Hong Kong - epidemiology; Humans; Hyperglycemia; Hypertension; Insulin resistance; Kidney Neoplasms - epidemiology; Kidney Neoplasms - etiology; lipid disorders; Lipids; Liver cancer; Liver cirrhosis; Medical diagnosis; Metabolism; Obesity; Obesity - complications; oncology; Outpatient care facilities; Pancreas; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - etiology; Patients; Primary care; Retrospective Studies; Risk Factors; Statins; Triglycerides
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-082414

ObjectivesTo compare metabolic dysfunction-associated profiles between patients with diabetes who developed different obesity-related site-specific cancers and those who remained free of cancer during follow-up.DesignRetrospective cohort study.SettingPublic general outpatient clinics in Hong Kong.ParticipantsPatients with diabetes without a history of malignancy (n=391 921).Primary outcome measuresThe outcomes of interest were diagnosis of site-specific cancers (colon and rectum, liver, pancreas, bladder, kidney and stomach) during follow-up. Cox proportional hazards regression was applied to assess the associations between metabolic dysfunction and other clinical factors with each site-specific cancer.ResultsEach 0.1 increase in waist-to-hip ratio was associated with an 11%–35% elevated risk of colorectal, bladder and liver cancers. Each 1% increase in glycated haemoglobin was linked to a 4%–9% higher risk of liver and pancreatic cancers. While low-density lipoprotein cholesterol and triglycerides were inversely associated with the risk of liver and pancreatic cancers, high-density lipoprotein cholesterol was negatively associated with pancreatic, gastric and kidney cancers, but positively associated with liver cancer. Furthermore, liver cirrhosis was linked to a 56% increased risk of pancreatic cancer. No significant association between hypertension and cancer risk was found.ConclusionsMetabolic dysfunction-associated profiles contribute to different obesity-related cancer outcomes differentially among patients with diabetes. This study may provide evidence to help identify cancer prevention targets during routine diabetes care.