Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the systemic effects of menopause, so you can help patients in your clinics through the transition.

Launching: Thursday 12th December 2024
ADVANCED SEARCH
Log in
Top
BMC Medicine
Published in:

Open Access 01-12-2024 | Research

Influence of impaired glucose tolerance and type 2 diabetes on the multimorbidity cluster of cardiovascular disease and cancer: a post hoc analysis of the Da Qing Diabetes Prevention Outcome Study

Authors: Fei Chen, Jinping Wang, Siyao He, Yifan He, Yali An, Qiuhong Gong, Xiaoping Chen, Ying Shuai, Xuan Wang, Yanyan Chen, Bo Zhang, Guangwei Li

Published in: BMC Medicine | Issue 1/2024

Login to get access

Abstract

Background

This study explored the influence of type 2 diabetes and impaired glucose tolerance (IGT) on the risk of the multimorbidity cluster of cardiovascular disease (CVD) and cancer.

Methods

A total of 1629 participants in the Da Qing Diabetes Prevention Outcome Study were recruited in the present analysis, including normal glucose tolerance (NGT, N = 492), IGT (N = 540), and newly diagnosed type 2 diabetes (N = 597) groups. Cox proportional hazards analyses were performed to assess the relationship between NGT, IGT, and newly diagnosed type 2 diabetes and the risk of the multimorbidity cluster of CVD and cancer.

Results

The incidence rates for multimorbidity cluster CVD and cancer were 1.25, 3.17, and 3.23 per 1000 person-years in people with NGT, IGT, and the newly diagnosed type 2 diabetes groups, respectively, over 34-year follow-up. Cox analysis revealed that diabetes status (as time-dependent variable) was significantly associated with the subsequent increased risk of multimorbidity cluster of CVD and cancer compared with non-diabetes (hazard ratios [HR] = 2.55, 95% confidence interval [CI] 1.51–4.31) after adjustment of potential confounders. Similar analysis showed that this risk was significantly higher in the IGT and newly diagnosed type 2 diabetes groups compared with NGT, with HR of 3.28 (95% CI 1.83–5.87) and HR of 3.90 (95% CI 2.14–7.09), respectively. Whereas compared diabetes with IGT group, this risk was not significantly different.

Conclusions

Similar to newly diagnosed type 2 diabetes, IGT is significantly associated with an increased risk of the multimorbidity cluster of CVD and cancer compared with NGT. This finding highlights the urgent need for an active detection of IGT and effective prevention and management of diabetes.
Appendix
Available only for authorised users
Literature
1.
Smith SM, Soubhi H, Fortin M, Hudon C, O’Dowd T. Managing patients with multimorbidity: systematic review of interventions in primary care and community settings. BMJ. 2012;345:e5205–e5205.CrossRefPubMedPubMedCentral
2.
Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396:1204–22.CrossRef
3.
Mensah GA, Roth GA, Fuster V. The global burden of cardiovascular diseases and risk factors. J Am Coll Cardiol. 2019;74:2529–32.CrossRefPubMed
4.
Liu S, Li Y, Zeng X, Wang H, Yin P, Wang L, et al. Burden of cardiovascular diseases in China, 1990–2016: findings from the 2016 Global Burden of Disease Study. JAMA Cardiol. 2019;4:342.CrossRefPubMedPubMedCentral
5.
Xia C, Dong X, Li H, Cao M, Sun D, He S, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J (Engl). 2022;135:584–90.CrossRefPubMed
6.
He S, Xia C, Li H, Cao M, Yang F, Yan X, et al. Cancer profiles in China and comparisons with the USA: a comprehensive analysis in the incidence, mortality, survival, staging, and attribution to risk factors. Sci China Life Sci. 2024;67:122–31.CrossRefPubMed
7.
Low LL, Kwan YH, Ko MSM, Yeam CT, Lee VSY, Tan WB, et al. Epidemiologic characteristics of multimorbidity and sociodemographic factors associated with multimorbidity in a rapidly aging Asian country. JAMA Netw Open. 2019;2: e1915245.CrossRefPubMedPubMedCentral
8.
Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med. 2002;162:2269.CrossRefPubMed
9.
Salisbury C, Johnson L, Purdy S, Valderas JM, Montgomery AA. Epidemiology and impact of multimorbidity in primary care: a retrospective cohort study. Br J Gen Pract. 2011;61:e12-21.CrossRefPubMed
10.
Pan X-R, Yang W-Y, Li G-W, Liu J, National Diabetes Prevention and Control Cooperative Group. Prevalence of diabetes and its risk factors in China, 1994. Diabetes Care. 1997;20:1664–9.
11.
Wenying Y, Juming L, Jianping W, Weiping J, Linong J, Jianzhong X, et al. Prevalence of diabetes among men and women in China. N Engl J Med. 2010;362:1090–101.CrossRef
12.
13.
Wang L, Gao P, Zhang M, Huang Z, Zhang D, Deng Q, et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013. JAMA. 2017;317:2515.CrossRefPubMedPubMedCentral
14.
15.
Ballotari P, Vicentini M, Manicardi V, Gallo M, Chiatamone Ranieri S, Greci M, et al. Diabetes and risk of cancer incidence: results from a population-based cohort study in northern Italy. BMC Cancer. 2017;17:703.CrossRefPubMedPubMedCentral
16.
Tsilidis KK, Kasimis JC, Lopez DS, Ntzani EE, Ioannidis JPA. Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies. BMJ. 2015;350: g7607.CrossRefPubMed
17.
Giovannucci E, Harlan DM, Archer MC, Bergenstal RM, Gapstur SM, Habel LA, et al. Diabetes and cancer: a consensus report. CA Cancer J Clin. 2010;60:207–21.CrossRefPubMed
18.
Gong Q, Zhang P, Wang J, Ma J, An Y, Chen Y, et al. Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance: 30-year results of the Da Qing Diabetes Prevention Outcome Study. Lancet Diabetes Endocrinol. 2019;7:452–61.CrossRefPubMedPubMedCentral
19.
Chen Y, Zhang P, Wang J, Gong Q, An Y, Qian X, et al. Associations of progression to diabetes and regression to normal glucose tolerance with development of cardiovascular and microvascular disease among people with impaired glucose tolerance: a secondary analysis of the 30 year Da Qing Diabetes Prevention Outcome Study. Diabetologia. 2021;64:1279–87.CrossRefPubMed
20.
An Y, Zhang P, Wang J, Gong Q, Gregg EW, Yang W, et al. Cardiovascular and all-cause mortality over a 23-year period among chinese with newly diagnosed diabetes in the Da Qing IGT and Diabetes Study. Diabetes Care. 2015;38:1365–71.CrossRefPubMedPubMedCentral
21.
WHO Consultation. diabetes_mellitus_1985.pdf. WHO. 1985.
22.
Freisling H, Viallon V, Lennon H, Bagnardi V, Ricci C, Butterworth AS, et al. Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study. BMC Med. 2020;18:5.CrossRefPubMedPubMedCentral
23.
Chang W-C, Hsieh T-C, Hsu W-L, Chang F-L, Tsai H-R, He M-S. Diabetes and further risk of cancer: a nationwide population-based study. BMC Med. 2024;22:214.CrossRefPubMedPubMedCentral
24.
Lin DY, Wei LJ, Ying Z. Checking the Cox model with cumulative sums of martingale-based residuals. Biometrika. 1993;80:557–72.CrossRef
25.
Ma C-X, Ma X-N, Guan C-H, Li Y-D, Mauricio D, Fu S-B. Cardiovascular disease in type 2 diabetes mellitus: progress toward personalized management. Cardiovasc Diabetol. 2022;21:74.CrossRefPubMedPubMedCentral
26.
Wong ND, Sattar N. Cardiovascular risk in diabetes mellitus: epidemiology, assessment and prevention. Nat Rev Cardiol. 2023;20:685–95.CrossRefPubMed
27.
Pearson-Stuttard J, Papadimitriou N, Markozannes G, Cividini S, Kakourou A, Gill D, et al. Type 2 diabetes and cancer: an umbrella review of observational and Mendelian randomization studies. Cancer Epidemiol Biomarkers Prev. 2021;30:1218–28.CrossRefPubMedPubMedCentral
28.
The DECODE Study Group, on behalf of the European Diabetes Epidemiology Group. Is the current definition for diabetes relevant to mortality risk from all causes and cardiovascular and noncardiovascular diseases? Diabetes Care. 2003;26:688–96.
29.
Nakagami T, Qiao Q, Tuomilehto J, Balkau B, Tajima N, Hu G, et al. Screen-detected diabetes, hypertension and hypercholesterolemia as predictors of cardiovascular mortality in five populations of Asian origin: the DECODA study. Eur J Cardiovasc Prev Rehabil. 2006;13:555–61.CrossRefPubMed
30.
for the DECODE Study Group, Zhou XH, Qiao Q, Zethelius B, Pyörälä K, Söderberg S, et al. Diabetes, prediabetes and cancer mortality. Diabetologia. 2010;53:1867–76.
31.
Oh S, Lee J, Hong YS, Kim K. Increased risk of cardiovascular disease associated with diabetes among adult cancer survivors: a population-based matched cohort study. Eur J Prev Cardiol. 2023;30:zwad046.
32.
Cordova R, Viallon V, Fontvieille E, Peruchet-Noray L, Jansana A, Wagner K-H, et al. Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study. Lancet Reg Health - Eur. 2023;35: 100771.CrossRefPubMedPubMedCentral
33.
Narayan KMV, Kondal D, Chang HH, Mohan D, Gujral UP, Anjana RM, et al. Natural history of type 2 diabetes in Indians: time to progression. Diabetes Care. 2024;47:858–63.CrossRefPubMedPubMedCentral
34.
Zhang L, Zhang Y, Shen S, Wang X, Dong L, Li Q, et al. Safety and effectiveness of metformin plus lifestyle intervention compared with lifestyle intervention alone in preventing progression to diabetes in a Chinese population with impaired glucose regulation: a multicentre, open-label, randomised controlled trial. Lancet Diabetes Endocrinol. 2023;11:567–77.CrossRefPubMed
35.
36.
Grundy SM. Pre-diabetes, metabolic syndrome, and cardiovascular risk. J Am Coll Cardiol. 2012;59:635–43.CrossRefPubMed
37.
Huang Y, Cai X, Qiu M, Chen P, Tang H, Hu Y, et al. Prediabetes and the risk of cancer: a meta-analysis. Diabetologia. 2014;57:2261–9.CrossRefPubMed
38.
39.
40.
41.
De Boer RA, Meijers WC, Van Der Meer P, Van Veldhuisen DJ. Cancer and heart disease: associations and relations. Eur J Heart Fail. 2019;21:1515–25.CrossRefPubMed
42.
Petrie JR, Guzik TJ, Touyz RM. Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms. Can J Cardiol. 2018;34:575–84.CrossRefPubMed
43.
Dokken BB. The pathophysiology of cardiovascular disease and diabetes: beyond blood pressure and lipids. Diabetes Spectr. 2008;21:160–5.CrossRef
44.
Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuñiga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018;17:122.CrossRefPubMedPubMedCentral
45.
Metadata
Title
Influence of impaired glucose tolerance and type 2 diabetes on the multimorbidity cluster of cardiovascular disease and cancer: a post hoc analysis of the Da Qing Diabetes Prevention Outcome Study
Authors
Fei Chen
Jinping Wang
Siyao He
Yifan He
Yali An
Qiuhong Gong
Xiaoping Chen
Ying Shuai
Xuan Wang
Yanyan Chen
Bo Zhang
Guangwei Li
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2024
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-024-03749-6

Other articles of this Issue 1/2024

Are Dutch adults equally susceptible to nudging and pricing strategies? Secondary analyses of the Supreme Nudge parallel cluster-randomised controlled supermarket trial

  • Open Access
  • Original Research

The neural and genetic underpinnings of different developmental trajectories of Attention-Deficit/Hyperactivity Symptoms in children and adolescents

Gain of bipolar disorder-related lncRNA AP1AR-DT in mice induces depressive and anxiety-like behaviors by reducing Negr1-mediated excitatory synaptic transmission

  • Open Access
  • Research

Correlates of protection and determinants of SARS-CoV-2 breakthrough infections 1 year after third dose vaccination

Impact of preconception and antenatal supplementation with myo-inositol, probiotics, and micronutrients on offspring BMI and weight gain over the first 2 years

Comparison of children and adults in deep brain stimulation for Tourette Syndrome: a large-scale multicenter study of 102 cases with long-term follow-up

Keynote webinar | Spotlight on adolescent vaping

  • Live
  • Webinar | 29-01-2025 | 18:00 (CET)

Growing numbers of young people are using e-cigarettes, despite warnings of respiratory effects and addiction. How can doctors tackle the epidemic, and what health effects should you prepare to manage in your clinics?

Watch it live: Wednesday 29th January, 18:00-19:30 CET
 

Prof. Ann McNeill
Dr. Debbie Robson
Benji Horwell
Developed by: Springer Medicine
Join the webinar

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Read more
Image Credits