Assessment of the prognostic cancer risk in patients with type 2 diabetes mellitus

Main Article Content

T.S. Vatseba
L.K. Sokolova
N.M. Koshel

Abstract

Background. The epidemiological analysis has shown an increased risk of cancer of the mammalian gland (MG), ute­rine body, and pancreas in patients with type 2 diabetes mellitus (T2DM). The different clinical characteristics and features of the course of DM, and schemes of treatment of patients with these types of oncological diseases (OD) were identified. The purpose of the study was to create a model of mathematical calculation and assessment of the predicted risk of cancer of MG, uterine body, pancreatic and colorectal cancer (CRC) in patients with T2DM, given the importance of diabetes-associated factors of oncogenesis. Materials and methods. The study included an analysis of medical records of patients with T2DM with first diagnosed OD during 2012–2016. The statistical analysis of the results was performed in the program Statistica 12.0 (StatSoft Inc., USA). The differences between indicators were determined by Student’s t-test, considered significant at p < 0.05. The method of multi-factor analysis and the logistic regression equation was used to calculate the coefficient of prognostic risk of the OD. Results. It was found that cancer of MG and the uterine body was most often diagnosed in people at the age of 60–70 years, with obesity, duration of DM more than 5 years, with HbA1c level > 7.5 %, on combination therapy with drugs without influence on the insulin synthesis with stimulators of insulin production. Patients with CRC had the same characteristics, without gender diffe­rences. Pancreatic cancer was most often diagnosed in patients aged 60–70 years, without obesity, with a duration of DM up to 5 years, with HbA1c > 7.5 %, on monotherapy with insulin or sulfonylureas, without gender differences. The created model for calculating the coefficient of the prognostic risk of MG and uterine body cancer is characterized by high prognostic power (accuracy 76.24 %), good prognostic power for cancer of the pancreas (accuracy 75.0 %), and CRC (accuracy 72.2 %). Conclusions. Correction of dysmetabolic disorders is a method of prevention of OD in patients with T2DM. The calculation of the predicted cancer risk will contribute to the prevention of malignant neoplasms in patients with T2DM.

Article Details

How to Cite
Vatseba, T., L. Sokolova, and N. Koshel. “Assessment of the Prognostic Cancer Risk in Patients With Type 2 Diabetes Mellitus”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 17, no. 1, Apr. 2021, pp. 86-91, doi:10.22141/2224-0721.17.1.2021.226437.
Section
Original Researches

References

Larsson SC, Orsini N, Wolk A. Diabetes mellitus and risk of colorectal cancer: a meta-analysis. J Natl Cancer Inst. 2005 Nov 16;97(22):1679-87. doi:10.1093/jnci/dji375.

Larsson SC, Mantzoros CS, Wolk A. Diabetes mellitus and risk of breast cancer: a meta-analysis. Int J Cancer. 2007 Aug 15;121(4):856-62. doi:10.1002/ijc.22717.

Huxley R, Ansary-Moghaddam A, Berrington de González A, Barzi F, Woodward M. Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer. 2005 Jun 6;92(11):2076-83. doi:10.1038/sj.bjc.6602619.

Ben Q, Xu M, Ning X, et al. Diabetes mellitus and risk of pancreatic cancer: A meta-analysis of cohort studies. Eur J Cancer. 2011 Sep;47(13):1928-37. doi:10.1016/j.ejca.2011.03.003.

Oberaigner W, Ebenbichler C, Oberaigner K, Juchum M, Schönherr HR, Lechleitner M. Increased cancer incidence risk in type 2 diabetes mellitus: results from a cohort study in Tyrol/Austria. BMC Public Health. 2014 Oct 10;14:1058. doi:10.1186/1471-2458-14-1058.

Carstensen B, Jørgensen ME, Friis S. The epidemiology of diabetes and cancer. Curr Diab Rep. 2014 Oct;14(10):535. doi:10.1007/s11892-014-0535-8.

Gordon-Dseagu VL, Shelton N, Mindell JS. Epidemiological evidence of a relationship between type-1 diabetes mellitus and cancer: a review of the existing literature. Int J Cancer. 2013 Feb 1;132(3):501-8. doi:10.1002/ijc.27703.

Vatseba TS, Sokolova LK, Kuzenko RT. Epidemiology of pancreatic cancer in patients with type 2 diabetes mellitus in the ivano-frankivsk region. Probl Endocr Pathol. 2020;1:14-22. doi:10.21856/j-PEP.2020.1.02. (in Ukrainian).

Zinger A, Cho WC, Ben-Yehuda A. Cancer and Aging - the Inflammatory Connection. Aging Dis. 2017 Oct 1;8(5):611-627. doi:10.14336/AD.2016.1230.

Masur K, Vetter C, Hinz A, et al. Diabetogenic glucose and insulin concentrations modulate transcriptome and protein levels involved in tumour cell migration, adhesion and proliferation. Br J Cancer. 2011 Jan 18;104(2):345-52. doi:10.1038/sj.bjc.6606050.

Ryu TY, Park J, Scherer PE. Hyperglycemia as a risk factor for cancer progression. Diabetes Metab J. 2014 Oct;38(5):330-6. doi:10.4093/dmj.2014.38.5.330.

Pacher P, Beckman JS, Liaudet L. Nitric oxide and peroxynitrite in health and disease. Physiol Rev. 2007 Jan;87(1):315-424. doi:10.1152/physrev.00029.2006.

Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011 Mar 4;144(5):646-74. doi:10.1016/j.cell.2011.02.013.

Drel VR. Main mechanisms of the initiation and development of diabetic complications: the role of nitrative stress. Biol Stud. 2010;4(2):141–158. doi:10.30970/sbi.0402.085. (in Ukrainian).

Heuson JC, Legros N, Heimann R. Influence of insulin administration on growth of the 7,12-dimethylbenz(a)anthracene-induced mammary carcinoma in intact, oophorectomized, and hypophysectomized rats. Cancer Res. 1972 Feb;32(2):233-8.

Kennedy L, Sandhu JK, Harper ME, Cuperlovic-Culf M. Role of Glutathione in Cancer: From Mechanisms to Therapies. Biomolecules. 2020 Oct 9;10(10):1429. doi:10.3390/biom10101429.

Martin RM, Vatten L, Gunnell D, Romundstad P, Nilsen TI. Components of the metabolic syndrome and risk of prostate cancer: the HUNT 2 cohort, Norway. Cancer Causes Control. 2009 Sep;20(7):1181-92. doi:10.1007/s10552-009-9319-x.

Vatseba TS, Sokolova LK, Pushkarev VM. The effect of obesity on the formation of cancer risk in patients with type 2 diabetes mellitus (literature review). Mìžnarodnij endokrinologìčnij žurnal. 2020;16(2):161-167. doi:10.22141/2224-0721.16.2.2020.201303. (in Ukrainian).

Wu Y, Liu Y, Dong Y, Vadgama J. Diabetes-associated dysregulated cytokines and cancer. Integr Cancer Sci Ther. 2016 Feb;3(1):370-378. doi:10.15761/ICST.1000173.

McNabney SM, Henagan TM. Short Chain Fatty Acids in the Colon and Peripheral Tissues: A Focus on Butyrate, Colon Cancer, Obesity and Insulin Resistance. Nutrients. 2017 Dec 12;9(12):1348. doi:10.3390/nu9121348.

Ballotari P, Vicentini M, Manicardi V, et al. Diabetes and risk of cancer incidence: results from a population-based cohort study in northern Italy. BMC Cancer. 2017 Oct 25;17(1):703. doi:10.1186/s12885-017-3696-4.

Batandier C, Guigas B, Detaille D, et al. The ROS production induced by a reverse-electron flux at respiratory-chain complex 1 is hampered by metformin. J Bioenerg Biomembr. 2006 Feb;38(1):33-42. doi:10.1007/s10863-006-9003-8.

Kalender A, Selvaraj A, Kim SY, et al. Metformin, independent of AMPK, inhibits mTORC1 in a rag GTPase-dependent manner. Cell Metab. 2010 May 5;11(5):390-401. doi:10.1016/j.cmet.2010.03.014.

Cui Y, Andersen DK. Diabetes and pancreatic cancer. Endocr Relat Cancer. 2012 Sep 5;19(5):F9-F26. doi:10.1530/ERC-12-0105.

Andersen DK, Korc M, Petersen GM, et al. Diabetes, Pancreatogenic Diabetes, and Pancreatic Cancer. Diabetes. 2017 May;66(5):1103-1110. doi:10.2337/db16-1477.