Endogenous incretin levels and risk of first incident cancer: a prospective cohort study

• Published in: Scientific reports 2023-01, Vol.13 (1), p.382-382, Article 382
• Main Authors: Jujić, Amra, Godina, Christopher, Belting, Mattias, Melander, Olle, Juul Holst, Jens, Ahlqvist, Emma, Gomez, Maria F., Nilsson, Peter M., Jernström, Helena, Magnusson, Martin
• Format: Article
• Language: English
• Subjects: 631/67; 692/163; Aged; Blood Glucose; Cancer; Cancer and Oncology; Cancer och onkologi; Clinical Medicine; Cohort analysis; Fasting; Female; Gastric Inhibitory Polypeptide; GLP-1 receptor agonists; Glucagon; Glucagon-Like Peptide 1; Glucose tolerance; Health risks; Humanities and Social Sciences; Humans; Incretins; Insulin; Klinisk medicin; Male; Medical and Health Sciences; Medicin och hälsovetenskap; multidisciplinary; Neoplasms - epidemiology; Peptides; Prospective Studies; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-27509-3

Concerns have been raised regarding a potentially increased risk of cancer associated with treatment with glucagon-like peptide-1 (GLP-1) receptor agonists. Here, we explored whether fasting and oral glucose tolerance test post-challenge glucose-dependent insulinotropic peptide (GIP) and GLP-1 levels were associated with incident first cancer. Within the cardiovascular re-examination arm of the population-based Malmö Diet Cancer study (n = 3734), 685 participants with a previous cancer diagnosis were excluded, resulting in 3049 participants (mean age 72.2 ± 5.6 years, 59.5% women), of whom 485 were diagnosed with incident first cancer (median follow-up time 9.9 years). Multivariable Cox-regression and competing risk regression (death as competing risk) were used to explore associations between incretin levels and incident first cancer. Higher levels of fasting GLP-1 (462 incident first cancer cases/2417 controls) showed lower risk of incident first cancer in competing risk regression (sub-hazard ratio 0.90; 95% confidence interval 0.82–0.99; p = 0.022). No association was seen for fasting GIP, post-challenge GIP, or post-challenge GLP-1 and incident first cancer. In this prospective study, none of the fasting and post-challenge levels of GIP and GLP-1 were associated with higher risk of incident first cancer; by contrast, higher levels of fasting GLP-1 were associated with lower risk of incident first cancer.