糖尿病患者罹患結直腸癌危險性的Meta分析_《中國循證醫學雜志》

作者：

邵琦 ,  任穎 , 趙催春 , 汪紅平

上海交通大學附屬第六人民醫院特需醫療科，上海市糖尿病臨床醫學中心（上海?200233）;

關鍵詞：

糖尿病結直腸癌隊列研究 Meta分析

DOI：

10.7507/1672-2531.20110093

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價糖尿病與結直腸癌發生率的相關性，以期為糖尿病患者結直腸癌的早期篩查提供較為客觀的依據。
方法　計算機檢索MEDLINE和EMbase，檢索時限為1990年1月至2010年7月，查找糖尿病患者發生結直腸癌風險性的相關隊列研究，按照納入排除標準進行文獻篩選、資料提取和質量評價后，采用RevMan 4.3軟件進行Meta分析。
結果　共納入17項研究，包括1 690 869例研究對象。Meta分析結果顯示：糖尿病患者結直腸癌發生率較對照組高，差異有統計學意義［16.50‰ vs. 10.13‰；OR=1.43，95%CI（1.29，1.60）］。亞組分析顯示，無論男性和女性糖尿病患者，其患結直腸癌危險性均較對照組高；男性糖尿病患者風險稍高于女性（OR：1.47 vs. 1.41）。
結論　糖尿病是結直腸癌發生的危險因素之一。

引用本文： 邵琦,任穎,趙催春,汪紅平. 糖尿病患者罹患結直腸癌危險性的Meta分析. 中國循證醫學雜志, 2011, 11(5): 518-523. doi: 10.7507/1672-2531.20110093 復制

1.	1 Hjartåker A, Langseth H, Weiderpass E. Obesity and diabetes epidemics: cancer repercussions. Adv Exp Med Biol , 2008, 630: 72-93.
2.	2 Chung YC, Chaen YL, Hsu CP. Clinical significance of tissue expression of interleukin-6 in colorectal carcinoma. Anticancer Res , 2006, 26(5B): 3905-3911.
3.	3 Pellegrini M, Marzocca G. Obesity, insulin-like growth factors and colorectal cancer. Panminerva Med , 2006, 48(2): 143-144.
4.	4 Wells GA, Shea B, O’Connell D, et al . The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. The Ottawa Health Research Institute, 2010.
5.	5 Steenland K, Nowlin S, Palu S. Cancer incidence in the National Health and Nutrition Survey I. Follow-up data: diabetes, cholesterol, pulse and physical activity. Cancer Epidemiol Biomarkers Prev , 1995, 4(8): 807-811.
6.	6 Will JC, Galuska DA, Vinicor F, et al . Colorectal cancer: another complication of diabetes mellitus? Am J Epidemiol , 1998, 147(9): 816-825.
7.	7 Hu FB, Manson JE, Liu S, et al . Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women. J Natl Cancer Inst , 1999, 91(6): 542-547.
8.	8 Schoen RE, Tangen CM, Kuller LH, et al . Increased blood glucose and insulin, body size, and incident colorectal cancer. J Natl Cancer Inst , 1999, 91(13): 1147-1154.
9.	9 Nilsen TI, Vatten LJ. Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinaemia hypothesis. Br J Cancer , 2001, 84(3): 417-422.
10.	10 Sandhu MS, Luben R, Khaw KT. Self reported non-insulin dependent diabetes, family history, and risk of prevalent colorectal cancer: population based, cross sectional study. J Epidemiol Community Health , 2001, 55(11): 804-805.
11.	11 Khaw KT, Wareham N, Bingham S, et al . Preliminary communication: glycated hemoglobin, diabetes, and incident colorectal cancer in men and women: a prospective analysis from the European prospective investigation into cancer-Norfolk study. Cancer Epidemiol Biomarkers Prev , 2004, 13(6): 915-919.
12.	12 Limburg PJ, Anderson KE, Johnson TW, et al . Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women's Health Study. Cancer Epidemiol Biomarkers Prev , 2005, 14(1): 133-137.
13.	13 Larsson SC, Giovannucci E, Wolk A. Diabetes and colorectal cancer incidence in the cohort of Swedish men. Diabetes Care , 2005, 28(7): 1805-1807.
14.	14 Seow A, Yuan JM, Koh WP, et al . Diabetes mellitus and risk of colorectal cancer in the Singapore Chinese Health Study. J Natl Cancer Inst , 2006, 98(2): 135-138.
15.	15 Inoue M, Iwasaki M, Otani T, et al . Diabetes mellitus and the risk of cancer: results from a large-scale population-based cohort study in Japan. Arch Intern Med , 2006, 166(17): 1871-1877.
16.	16 Ahmed RL, Schmitz KH, Anderson KE, et al . The metabolic syndrome and risk of incident colorectal cancer. Cancer , 2006, 107(1): 28-36.
17.	17 Bowers K, Albanes D, Limburg P, et al . A prospective study of anthropometric and clinical measurements associated with insulin resistance syndrome and colorectal cancer in male smokers. Am J Epidemiol , 2006, 164(7): 652-664.
18.	18 Stürmer T, Buring JE, Lee IM, et al . Metabolic abnormalities and risk for colorectal cancer in the physicians' health study. Cancer Epidemiol Biomarkers Prev , 2006, 15(12): 2391-2397.
19.	19 Ogunleye AA, Ogston SA, Morris AD, et al . A cohort study of the risk of cancer associated with type 2 diabetes. Br J Cancer , 2009, 101(7): 1199-1201.
20.	20 Flood A, Strayer L, Schairer C, et al . Diabetes and risk of incident colorectal cancer in a prospective cohort of women. Cancer Causes Control , 2010, 21(8): 1277-1284.
21.	21 He J, Stram DO, Kolonel LN, et al . The association of diabetes with colorectal cancer risk: the Multiethnic Cohort. Br J Cancer , 2010, 103(1): 120-126.
22.	22 Huang XF, Chen JZ. Obesity, the PI3K/Akt signal pathway and colon cancer. Obes Rev , 2009, 10(6): 610-616.
23.	23 Jin T. Why diabetes patients are more prone to the development of colon cancer? Med Hypotheses , 2008, 71(2): 241-244.
24.	24 Pais R, Silaghi H, Silaghi AC, et al . Metabolic syndrome and risk of subsequent colorectal cancer. World J Gastroenterol , 2009, 15(41): 5141-5148.
25.	25 Siddiqui AA. Metabolic syndrome and its association with colorectal cancer: a review. Am J Med Sci , 2011, 341(3):227-231.
26.	26 Pelucchi C, Negri E, Talamini R, et al . Metabolic syndrome is associated with colorectal cancer in men. Eur J Cancer , 2010, 46(10): 1866-1872.
27.	27 Schiel R, Müller UA, Braun A, et al . Risk of malignancies in patients with insulin-treated diabetes mellitus: results of a population-based trial with 10-year follow-up (JEVIN). Eur J Med Res , 2005, 10(8): 339-344.
28.	28 Nicolucci A. Epidemiological aspects of neoplasms in diabetes. Acta Diabetol , 2010, 47(2): 87-95.
29.	29 Wang D, Dubois RN. The role of COX-2 in intestinal inflammation and colorectal cancer. Oncogene , 2010, 29(6): 781-788.
30.	30 Malicki S, Winiarski M, Matlok M, et al . IL-6 and IL-8 responses of colorectal cancer in vivo and in vitro cancer cells subjected to simvastatin. J Physiol Pharmacol , 2009, 60(4): 141-146.
31.	31 Lee MS, Hsu CC, Wahlqvist ML, et al . Type 2 diabetes increases and metformin reduces total, colorectal, liver and pancreatic cancer incidences in Taiwanese: a representative population prospective cohort study of 800,000 individuals. BMC Cancer , 2011, 11: 20.
32.	32 Zhao G, Ford ES, Ahluwalia IB, et al . Prevalence and trends of receipt of cancer screenings among US women with diagnosed diabetes. J Gen Intern Med , 2009, 24(2): 270-275.
33.	33 Giouleme O, Diamantidis MD, Katsaros MG. Is diabetes a causal agent for colorectal cancer? Pathophysiological and molecular mechanisms. World J Gastroenterol , 2011, 17(4): 444-448.
34.	34 Campbell PT, Deka A, Jacobs EJ, et al . Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men. Gastroenterology , 2010, 139(4): 1138-1146.
35.	35 Rensing KL, Houttuijn Bloemendaal FM, Weijers EM, et al . Could recombinant insulin compounds contribute to adenocarcinoma progression by stimulating local angiogenesis? Diabetologia , 2010, 53(5): 966-970.

1. 1 Hjartåker A, Langseth H, Weiderpass E. Obesity and diabetes epidemics: cancer repercussions. Adv Exp Med Biol , 2008, 630: 72-93.
2. 2 Chung YC, Chaen YL, Hsu CP. Clinical significance of tissue expression of interleukin-6 in colorectal carcinoma. Anticancer Res , 2006, 26(5B): 3905-3911.
3. 3 Pellegrini M, Marzocca G. Obesity, insulin-like growth factors and colorectal cancer. Panminerva Med , 2006, 48(2): 143-144.
4. 4 Wells GA, Shea B, O’Connell D, et al . The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. The Ottawa Health Research Institute, 2010.
5. 5 Steenland K, Nowlin S, Palu S. Cancer incidence in the National Health and Nutrition Survey I. Follow-up data: diabetes, cholesterol, pulse and physical activity. Cancer Epidemiol Biomarkers Prev , 1995, 4(8): 807-811.
6. 6 Will JC, Galuska DA, Vinicor F, et al . Colorectal cancer: another complication of diabetes mellitus? Am J Epidemiol , 1998, 147(9): 816-825.
7. 7 Hu FB, Manson JE, Liu S, et al . Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women. J Natl Cancer Inst , 1999, 91(6): 542-547.
8. 8 Schoen RE, Tangen CM, Kuller LH, et al . Increased blood glucose and insulin, body size, and incident colorectal cancer. J Natl Cancer Inst , 1999, 91(13): 1147-1154.
9. 9 Nilsen TI, Vatten LJ. Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinaemia hypothesis. Br J Cancer , 2001, 84(3): 417-422.
10. 10 Sandhu MS, Luben R, Khaw KT. Self reported non-insulin dependent diabetes, family history, and risk of prevalent colorectal cancer: population based, cross sectional study. J Epidemiol Community Health , 2001, 55(11): 804-805.
11. 11 Khaw KT, Wareham N, Bingham S, et al . Preliminary communication: glycated hemoglobin, diabetes, and incident colorectal cancer in men and women: a prospective analysis from the European prospective investigation into cancer-Norfolk study. Cancer Epidemiol Biomarkers Prev , 2004, 13(6): 915-919.
12. 12 Limburg PJ, Anderson KE, Johnson TW, et al . Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women's Health Study. Cancer Epidemiol Biomarkers Prev , 2005, 14(1): 133-137.
13. 13 Larsson SC, Giovannucci E, Wolk A. Diabetes and colorectal cancer incidence in the cohort of Swedish men. Diabetes Care , 2005, 28(7): 1805-1807.
14. 14 Seow A, Yuan JM, Koh WP, et al . Diabetes mellitus and risk of colorectal cancer in the Singapore Chinese Health Study. J Natl Cancer Inst , 2006, 98(2): 135-138.
15. 15 Inoue M, Iwasaki M, Otani T, et al . Diabetes mellitus and the risk of cancer: results from a large-scale population-based cohort study in Japan. Arch Intern Med , 2006, 166(17): 1871-1877.
16. 16 Ahmed RL, Schmitz KH, Anderson KE, et al . The metabolic syndrome and risk of incident colorectal cancer. Cancer , 2006, 107(1): 28-36.
17. 17 Bowers K, Albanes D, Limburg P, et al . A prospective study of anthropometric and clinical measurements associated with insulin resistance syndrome and colorectal cancer in male smokers. Am J Epidemiol , 2006, 164(7): 652-664.
18. 18 Stürmer T, Buring JE, Lee IM, et al . Metabolic abnormalities and risk for colorectal cancer in the physicians' health study. Cancer Epidemiol Biomarkers Prev , 2006, 15(12): 2391-2397.
19. 19 Ogunleye AA, Ogston SA, Morris AD, et al . A cohort study of the risk of cancer associated with type 2 diabetes. Br J Cancer , 2009, 101(7): 1199-1201.
20. 20 Flood A, Strayer L, Schairer C, et al . Diabetes and risk of incident colorectal cancer in a prospective cohort of women. Cancer Causes Control , 2010, 21(8): 1277-1284.
21. 21 He J, Stram DO, Kolonel LN, et al . The association of diabetes with colorectal cancer risk: the Multiethnic Cohort. Br J Cancer , 2010, 103(1): 120-126.
22. 22 Huang XF, Chen JZ. Obesity, the PI3K/Akt signal pathway and colon cancer. Obes Rev , 2009, 10(6): 610-616.
23. 23 Jin T. Why diabetes patients are more prone to the development of colon cancer? Med Hypotheses , 2008, 71(2): 241-244.
24. 24 Pais R, Silaghi H, Silaghi AC, et al . Metabolic syndrome and risk of subsequent colorectal cancer. World J Gastroenterol , 2009, 15(41): 5141-5148.
25. 25 Siddiqui AA. Metabolic syndrome and its association with colorectal cancer: a review. Am J Med Sci , 2011, 341(3):227-231.
26. 26 Pelucchi C, Negri E, Talamini R, et al . Metabolic syndrome is associated with colorectal cancer in men. Eur J Cancer , 2010, 46(10): 1866-1872.
27. 27 Schiel R, Müller UA, Braun A, et al . Risk of malignancies in patients with insulin-treated diabetes mellitus: results of a population-based trial with 10-year follow-up (JEVIN). Eur J Med Res , 2005, 10(8): 339-344.
28. 28 Nicolucci A. Epidemiological aspects of neoplasms in diabetes. Acta Diabetol , 2010, 47(2): 87-95.
29. 29 Wang D, Dubois RN. The role of COX-2 in intestinal inflammation and colorectal cancer. Oncogene , 2010, 29(6): 781-788.
30. 30 Malicki S, Winiarski M, Matlok M, et al . IL-6 and IL-8 responses of colorectal cancer in vivo and in vitro cancer cells subjected to simvastatin. J Physiol Pharmacol , 2009, 60(4): 141-146.
31. 31 Lee MS, Hsu CC, Wahlqvist ML, et al . Type 2 diabetes increases and metformin reduces total, colorectal, liver and pancreatic cancer incidences in Taiwanese: a representative population prospective cohort study of 800,000 individuals. BMC Cancer , 2011, 11: 20.
32. 32 Zhao G, Ford ES, Ahluwalia IB, et al . Prevalence and trends of receipt of cancer screenings among US women with diagnosed diabetes. J Gen Intern Med , 2009, 24(2): 270-275.
33. 33 Giouleme O, Diamantidis MD, Katsaros MG. Is diabetes a causal agent for colorectal cancer? Pathophysiological and molecular mechanisms. World J Gastroenterol , 2011, 17(4): 444-448.
34. 34 Campbell PT, Deka A, Jacobs EJ, et al . Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men. Gastroenterology , 2010, 139(4): 1138-1146.
35. 35 Rensing KL, Houttuijn Bloemendaal FM, Weijers EM, et al . Could recombinant insulin compounds contribute to adenocarcinoma progression by stimulating local angiogenesis? Diabetologia , 2010, 53(5): 966-970.

《中國循證醫學雜志》

糖尿病患者罹患結直腸癌危險性的Meta分析

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《中國循證醫學雜志》

糖尿病患者罹患結直腸癌危險性的Meta分析

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