糖尿病、吸烟对胰腺癌发病的影响及相互作用

韩晓; 马冬梅; 凌志; 董小武; 严雪冰; 陈勇; 路国涛; 殷旭东

doi:10.7619/jcmp.20222463

糖尿病、吸烟对胰腺癌发病的影响及相互作用

Effects of diabetes and smoking on occurrence of pancreatic cancer and their interaction

摘要

摘要:
目的探讨糖尿病、吸烟对胰腺癌(PC)的影响和两者之间的相互作用。
方法基于英国生物样本数据库(UKB)中约50万名参与者的表型数据, 将研究对象分为糖尿病人群和非糖尿病人群、吸烟人群和非吸烟人群。应用多变量调整的Logistic回归模型分析吸烟、糖尿病与PC事件之间的关联性，并应用加性模型评估2种危险因素之间的相互作用。
结果本研究共纳入492 637名研究对象，其中包含1 223名PC患者和491 414名非PC患者。调整年龄、性别、种族、体质量指数(BMI)等混杂因素后发现，糖尿病人群(OR=1.999, 95%CI: 1.704~2.344)、吸烟人群(OR=1.246, 95%CI: 1.109~1.400) PC患病风险分别高于非糖尿病人群、非吸烟人群，差异有统计学意义(P < 0.05)。吸烟且有糖尿病病史人群相较于从不吸烟且无糖尿病史人群PC发病风险增加了近4倍(OR=3.561, 95%CI: 2.949~4.300, P < 0.001)。
结论糖尿病和吸烟是PC的独立危险因素，两者之间相互作用增加PC的患病风险。

Abstract:
Objective To investigate the effects of diabetes and smoking on occurrence of pancreatic cancer (PC) and their interaction.
Methods Based on the phenotype data of about 500 000 participants in the UK Bio-bank (UKB), the subjects were divided into people with diabetes and non-diabeties, smokers and non-smokers. Multivariate adjusted Logistic regression model was used to analyze the association between smoking, diabetes and PC. The interaction between the two risk factors was assessed by an additive model.
Results A total of 492 637 participants were included, including 1 223 patients with PC and 491 414 patients without PC. After adjusting for age, gender, race, body mass index (BMI) and other confounding factors, it was founded that the risk of PC in people with diabetes (OR=1.999, 95%CI, 1.704 to 2.344) and people with smoking (OR=1.246, 95%CI, 1.109 to 1.400) were significantly higher than those of people with non-diabetes or non-smokers (P < 0.05). People who smoked and had a history of diabetes had a nearly 4-fold increased risk of developing PC compared with those who never smoked and had no history of diabetes (OR=3.561, 95%CI, 2.949 to 4.300, P < 0.001).
Conclusion Diabetes and smoking are independent risk factors for PC, and their interaction increases the risk of PC.

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