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首页> 外文期刊>Diabetes care >Association of Type 2 Diabetes With Cancer: A Meta-analysis With Bias Analysis for Unmeasured Confounding in 151 Cohorts Comprising 32 Million People
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Association of Type 2 Diabetes With Cancer: A Meta-analysis With Bias Analysis for Unmeasured Confounding in 151 Cohorts Comprising 32 Million People

机译：2型糖尿病与癌症的关联：在包括3200万人的151个群组中对未测量混淆的偏见分析进行了荟萃分析

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BACKGROUND AND PURPOSE Whether the association between type 2 diabetes (T2D) and cancer is causal remains controversial. The goal of this work is to assess the robustness of the observational associations between T2D and cancer to unmeasured confounding. DATA SOURCES AND STUDY SELECTION PubMed, Web of Science, and the Cochrane library were systematically searched on 10 January 2019 for observational studies investigating associations between T2D and cancer incidence or mortality. DATA EXTRACTION AND DATA SYNTHESIS Cohort-level relative risk (RR) was extracted. RRs were combined in random-effects meta-analyses and pooled estimates used in bias analyses. A total of 151 cohorts (over 32 million people, 1.1 million cancer cases, and 150,000 cancer deaths) were included. In meta-analyses, T2D was associated with incidence of several cancers, from prostate (RR 0.83; 95% CI 0.79, 0.88) to liver (2.23; 1.99, 2.49), and with mortality from pancreatic cancer (1.67; 1.30, 2.14). In bias analyses, assuming an unmeasured confounding associated with both T2D and cancer with a RR of 1.5, the proportion of studies with a true effect size larger than a RR of 1.1 (i.e., 10% increased risk in individuals with T2D) was nearly 100% for liver, pancreatic, and endometrial, 86% for gallbladder, 67% for kidney, 64% for colon, 62% for colorectal, and <50% for other cancer incidences, and 92% for pancreatic cancer mortality. LIMITATIONS Biases other than unmeasured confounding were not analytically assessed. CONCLUSIONS Our findings strongly suggest a causal association between T2D and liver, pancreatic, and endometrial cancer incidence, and pancreatic cancer mortality. Conversely, associations with other cancers were less robust to unmeasured confounding.
机译：背景和目的是2型糖尿病（T2D）和癌症之间的关联是否存在争议。这项工作的目标是评估T2D与癌症之间观察协会的稳健性，以对未测量的混淆。 2019年1月10日，系统地检测数据来源和学习选择，科学网站和Cochrane图书馆进行了调查T2D和癌症发病率或死亡率之间的关联的观察研究。提取数据提取和数据合成群体相对风险（RR）。 RRS在随机效应的元分析中组合，并在偏见分析中使用的汇总估计。包括共有151个队列（超过3200万人，110万癌症病例和150,000名癌症死亡）。在Meta分析中，T2D与几种癌症的发病率相关，来自前列腺（RR 0.83; 95％CI 0.79,0.88）至肝脏（2.23; 1.99,2.49），以及来自胰腺癌的死亡率（1.67; 1.30,2.14） 。在偏见分析中，假设与T2D和RR的癌症相关的未测量混淆，RR为1.5，真正效应大小的研究比例大于1.1的RR（即，T2D个体的个体的风险增加10％）是近100肝脏，胰腺和子宫内膜的％，胆囊的86％，肾脏67％，结肠64％，结肠直肠的62％，其他癌症发生率<50％，胰腺癌死亡率为<50％，胰腺癌死亡率为92％。没有分析评估除了未测量的混淆之外的局限性偏见。结论我们的研究结果强烈建议T2D和肝脏，胰腺癌和子宫内膜癌症发病率和胰腺癌死亡率之间的因果关系。相反，与其他癌症的关联对未测量的混杂性较低。

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  • 来源
    《Diabetes care》 |2020年第9期|共10页
  • 作者

    Ling Suping; Brown Karen; Miksza Joanne K.; Howells Lynne; Morrison Amy; Issa Eyad; Yates Thomas; Khunti Kamlesh; Davies Melanie J.; Zaccardi Francesco;

  • 作者单位

    Univ Leicester Coll Life Sci Leicester Diabet Res Ctr Leicester Leics England;

    Univ Leicester Leicester Canc Res Ctr Leicester Royal Infirm Leicester Leics England;

    Univ Leicester Coll Life Sci Leicester Diabet Res Ctr Leicester Leics England;

    Univ Leicester Leicester Canc Res Ctr Leicester Royal Infirm Leicester Leics England;

    Univ Leicester Coll Life Sci Leicester Diabet Res Ctr Leicester Leics England;

    Univ Leicester Leicester Canc Res Ctr Leicester Royal Infirm Leicester Leics England;

    Univ Leicester Coll Life Sci Leicester Diabet Res Ctr Leicester Leics England;

    Univ Leicester Coll Life Sci Leicester Diabet Res Ctr Leicester Leics England;

    Univ Leicester Coll Life Sci Leicester Diabet Res Ctr Leicester Leics England;

    Univ Leicester Coll Life Sci Leicester Diabet Res Ctr Leicester Leics England;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 内分泌腺疾病及代谢病;
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