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Diabetologia
Published in: Diabetologia 12/2011

01-12-2011 | Article

Diabetes mellitus, glycated haemoglobin and C-peptide levels in relation to pancreatic cancer risk: a study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Authors: V. A. Grote, S. Rohrmann, A. Nieters, L. Dossus, A. Tjønneland, J. Halkjær, K. Overvad, G. Fagherazzi, M. C. Boutron-Ruault, S. Morois, B. Teucher, S. Becker, D. Sluik, H. Boeing, A. Trichopoulou, P. Lagiou, D. Trichopoulos, D. Palli, V. Pala, R. Tumino, P. Vineis, S. Panico, L. Rodríguez, E. J. Duell, E. Molina-Montes, M. Dorronsoro, J. M. Huerta, E. Ardanaz, S. M. Jeurnink, J. W. J. Beulens, P. H. M. Peeters, M. Sund, W. Ye, B. Lindkvist, D. Johansen, K. T. Khaw, N. Wareham, N. Allen, F. Crowe, M. Jenab, I. Romieu, D. S. Michaud, E. Riboli, D. Romaguera, H. B. Bueno-de-Mesquita, R. Kaaks

Published in: Diabetologia | Issue 12/2011

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Abstract

Aims/hypothesis

There has been long-standing debate about whether diabetes is a causal risk factor for pancreatic cancer or a consequence of tumour development. Prospective epidemiological studies have shown variable relationships between pancreatic cancer risk and blood markers of glucose and insulin metabolism, overall and as a function of lag times between marker measurements (blood donation) and date of tumour diagnosis.

Methods

Pre-diagnostic levels of HbA1c and C-peptide were measured for 466 participants with pancreatic cancer and 466 individually matched controls within the European Prospective Investigation into Cancer and Nutrition. Conditional logistic regression models were used to estimate ORs for pancreatic cancer.

Results

Pancreatic cancer risk gradually increased with increasing pre-diagnostic HbA1c levels up to an OR of 2.42 (95% CI 1.33, 4.39 highest [≥6.5%, 48 mmol/mol] vs lowest [≤5.4%, 36 mmol/mol] category), even for individuals with HbA1c levels within the non-diabetic range. C-peptide levels showed no significant relationship with pancreatic cancer risk, irrespective of fasting status. Analyses showed no clear trends towards increasing hyperglycaemia (as marked by HbA1c levels) or reduced pancreatic beta cell responsiveness (as marked by C-peptide levels) with decreasing time intervals from blood donation to cancer diagnosis.

Conclusions/interpretation

Our data on HbA1c show that individuals who develop exocrine pancreatic cancer tend to have moderate increases in HbA1c levels, relatively independently of obesity and insulin resistance—the classic and major risk factors for type 2 diabetes. While there is no strong difference by lag time, more data are needed on this in order to reach a firm conclusion.
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Metadata
Title
Diabetes mellitus, glycated haemoglobin and C-peptide levels in relation to pancreatic cancer risk: a study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort
Authors
V. A. Grote
S. Rohrmann
A. Nieters
L. Dossus
A. Tjønneland
J. Halkjær
K. Overvad
G. Fagherazzi
M. C. Boutron-Ruault
S. Morois
B. Teucher
S. Becker
D. Sluik
H. Boeing
A. Trichopoulou
P. Lagiou
D. Trichopoulos
D. Palli
V. Pala
R. Tumino
P. Vineis
S. Panico
L. Rodríguez
E. J. Duell
E. Molina-Montes
M. Dorronsoro
J. M. Huerta
E. Ardanaz
S. M. Jeurnink
J. W. J. Beulens
P. H. M. Peeters
M. Sund
W. Ye
B. Lindkvist
D. Johansen
K. T. Khaw
N. Wareham
N. Allen
F. Crowe
M. Jenab
I. Romieu
D. S. Michaud
E. Riboli
D. Romaguera
H. B. Bueno-de-Mesquita
R. Kaaks
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 12/2011
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-011-2316-0

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