内科理论与实践 ›› 2022, Vol. 17 ›› Issue (06): 435-440.doi: 10.16138/j.1673-6087.2022.06.003

• 论著 • 上一篇    下一篇

上海糖尿病前期人群恶性肿瘤发病风险分析

缪雅1, 刘丽丽2, 侯田志超1, 严青华2, 庞怡2, 吴春晓2, 程旻娜2, 施燕2, 黎衍云2(), 田景琰1()   

  1. 1.上海交通大学医学院附属瑞金医院内分泌代谢病科 上海市内分泌代谢病研究所 临床研究中心,上海 200025
    2.上海市疾病预防控制中心 慢性非传染病与伤害防治所,上海 200336
  • 收稿日期:2022-11-14 出版日期:2022-12-30 发布日期:2023-02-27
  • 通讯作者: 黎衍云 E-mail: liyanyun@scdc.sh.cn;田景琰 E-mail: tianjypaper@163.com
  • 基金资助:
    上海市卫生健康委员会科研课题计划项目(202040209);转化医学国家重大科技基础设施(上海)开放课题项目(TMSK-2021-506)

Risk analysis of malignant tumor incidence in pre-diabetes patients in Shanghai

MIAO Ya1, LIU Lili2, HOU Tianzhichao1, YAN Qinghua2, PANG Yi2, WU Chunxiao2, CHENG Minna2, SHI Yan2, LI Yanyun2(), TIAN Jingyan1()   

  1. 1. Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 China
    2. Division of Chronic Non-Communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
  • Received:2022-11-14 Online:2022-12-30 Published:2023-02-27

摘要:

目的:探讨糖尿病前期患者全因肿瘤及特定部位肿瘤发病风险。方法:对2011年至2018年期间新诊断且纳入上海市社区糖尿病管理信息系统(Shanghai Standardized Diabetes Management System,SSDMS)31 568例20岁及以上的糖尿病前期患者,采用身份证号码作为唯一标识符,与上海市恶性肿瘤登记系统进行数据链接。获取其恶性肿瘤发病情况,计算不同性别、年龄的糖尿病前期患者全因及前10位恶性肿瘤发病率、标准化发病率及标准化发病率比(standard incidence ratio,SIR)。结果:糖尿病前期人群全因肿瘤发病率为868.1/10万人年,男性、女性分别为1 099.48/10万人年和729.19/10万人年;标化发病率为567.49/10万人年,男性、女性分别为512.15/10万人年和597.91/10万人年。全因肿瘤SIR为0.97,男性、女性均为0.99。糖尿病前期患者全因肿瘤相对发病风险随年龄上升呈逐渐下降趋势,20~49、50~59、60~69、70~79以及≥80岁组糖尿病前期人群SIR分别为3.04、1.21、1.00、0.92和 0.66。其中20~49岁和50~59岁组糖尿病前期人群甲状腺癌的发病风险分别是同年龄总人群的4.85和1.86倍,女性20~49岁和50~59岁组糖尿病前期人群分别是同性别、年龄总人群的4.46和1.53倍。50岁以下组男性糖尿病前期人群膀胱癌和肾癌风险分别是同性别、年龄总人群的36.34和 13.49倍。60~69岁组男性糖尿病前期前列腺癌的风险是同性别、年龄总人群的2.66倍。结论:糖尿病前期人群全因肿瘤发病风险与全人群相比未见明显升高,全因肿瘤及特定部位肿瘤相对发病风险随年龄上升呈逐渐下降趋势。应加强对特定性别和特定年龄人群特定癌种的筛查。对于80岁以上新发糖尿病前期者,建议重新评估疾病诊断及预后的风险。

关键词: 糖尿病前期, 恶性肿瘤, 标准化发病率, 标准

Abstract:

Objective To explore the risk of incidence of over all cancer and site-specific cancers in patients with pre-diabetes. Methods From 2011 to 2018, 31 568 pre-diabetes patients aged 20 years and above who were newly diagnosed and registered in the community diabetes management information system of Shanghai were used as the unique identifier to link data with the Shanghai Malignant Tumor Registration System to obtain their malignant tumor incidence, to calculate the incidence of all causes and the top ten malignant tumors of pre-diabetes patients of different sexes and ages standardized incidence rate and standardized incidence ratio (SIR). Results The crude incidence rate of all cause tumors in pre-diabetes patients was 868.1/100 000 person years, 1 099.48/100 000 person years for male and 729.19/100 000 person years for female. The standardized incidence rate was 567.49/100 000 person years, 512.15/100 000 person years for male and 597.91/100 000 person years for female. The SIR of all cause tumors was 0.97, 0.99 for male and 0.99 for female, respectively. The relative incidence risk of all cause tumors in pre-diabetes patients gradually decreased with age, and the SIR of pre-diabetes patients in the 20-49, 50-59, 60-69, 70-79 and ≥80 age groups was 3.04, 1.21, 1.00, 0.92 and 0.66, respectively. The incidence risk of thyroid cancer in the 20-49 and 50-59 year old pre-diabetes patients were 4.85 and 1.86 times higher than that of the total population of the same age, respectively, and the incidence risk of thyroid cancer in the 20-49 and 50-59 year old female pre-diabetes patients were 4.46 and 1.53 times higher than that of the total population of the same sex and age, respectively. The risk of bladder cancer and kidney cancer in male under 50 years of age with pre-diabetes were 36.34 and 13.49 times higher than that in the total population of the same sex and age, respectively. The risk of prostate cancer in male aged 60 to 69 years in pre-diabetes was 2.66 times higher than that in total population of the same sex and age. Conclusions The risk of all-cause cancer in pre-diabetes patients was not significantly higher than that in the total population. The relative risk of all-cause cancer and site-specific cancers of the population decreased with age. It is necessary to increase the screening of specific cancer species in specific gender and age groups. For newly diagnosed pre-diabetes patients over 80 years old, it is recommended to reevaluate the risk of disease diagnosis and prognosis.

Key words: Prediabetes, Malignant tumor, Standard incidence ratio, Standard

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