Elevated glycated haemoglobin (HbA1c) is associated with an increased risk of pancreatic ductal adenocarcinoma: a UK Biobank cohort study
Elevated glycated haemoglobin (HbA1c) is associated with an increased risk of pancreatic ductal adenocarcinoma: a UK Biobank cohort study
Background: the role of dysglycaemia as a risk marker for Pancreatic Ductal Adenocarcinoma (PDAC) is uncertain. We investigated the relationship between glycated haemoglobin (HbA1c) and incident PDAC using a retrospective cohort study within the UK Biobank.
Methods: a study involving 499,804 participants from the UK Biobank study was undertaken. Participants were stratified by diabetes mellitus (DM) status, and then by HbA1c values < 42 mmol/mol, 42-47 mmol/mol, or ≥48 mmol/mol. Cox proportional hazard models were used to describe the association between HbA1c category (with time-varying interactions) and incident PDAC.
Results: PDAC occurred in 1157 participants during 11.6 (10.9-12.3) years follow up [(median (interquartile range)]. In subjects without known DM at baseline, 12 months after recruitment, the adjusted hazard ratios (aHR, 95% CI) for incident PDAC for HbA1c 42-47 mmol/mol compared to HbA1c < 42 mmol/mol (reference group) was 2.10 (1.31-3.37, p = 0.002); and was 8.55 (4.58-15.99, p < 0.001) for HbA1c ≥ 48 mmol/mol. The association between baseline HbA1c and incident PDAC attenuated with increasing duration of time of follow-up to PDAC diagnosis.
Conclusions: dysglycaemia detected by elevated HbA1c is associated with an increased risk of PDAC. The strength of the association between elevated HbA1c and incident PDAC is inversely proportional to the time from detecting dysglycaemia but remains significant for at least 60 months following HbA1c testing.
adenocarcinoma, diabetes, HbA1c, NODM, pancreatic, PDAC, T3cDM
McDonnell, Declan
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Cheang, Adrian W.E.
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Wilding, Sam
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Wild, Sarah H.
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Frampton, Adam E.
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Byrne, Christopher D.
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Hamady, Zaed Z.
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McDonnell, Declan
b7499481-73e7-4130-897e-cd4200c8a43b
Cheang, Adrian W.E.
f65318d6-9a11-4fb7-8813-e8b6a95d7951
Wilding, Sam
1f316b8b-db59-4289-b6aa-183f957f3470
Wild, Sarah H.
b790195a-4aae-421b-81f7-2c18c96e6870
Frampton, Adam E.
d5cf9723-91a0-43f2-9ad2-cfd669eefcb5
Byrne, Christopher D.
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Hamady, Zaed Z.
545a1c81-276e-4341-a420-aa10aa5d8ca8
McDonnell, Declan, Cheang, Adrian W.E., Wilding, Sam, Wild, Sarah H., Frampton, Adam E., Byrne, Christopher D. and Hamady, Zaed Z.
(2023)
Elevated glycated haemoglobin (HbA1c) is associated with an increased risk of pancreatic ductal adenocarcinoma: a UK Biobank cohort study.
Cancers, 15 (16), [4078].
(doi:10.3390/cancers15164078).
Abstract
Background: the role of dysglycaemia as a risk marker for Pancreatic Ductal Adenocarcinoma (PDAC) is uncertain. We investigated the relationship between glycated haemoglobin (HbA1c) and incident PDAC using a retrospective cohort study within the UK Biobank.
Methods: a study involving 499,804 participants from the UK Biobank study was undertaken. Participants were stratified by diabetes mellitus (DM) status, and then by HbA1c values < 42 mmol/mol, 42-47 mmol/mol, or ≥48 mmol/mol. Cox proportional hazard models were used to describe the association between HbA1c category (with time-varying interactions) and incident PDAC.
Results: PDAC occurred in 1157 participants during 11.6 (10.9-12.3) years follow up [(median (interquartile range)]. In subjects without known DM at baseline, 12 months after recruitment, the adjusted hazard ratios (aHR, 95% CI) for incident PDAC for HbA1c 42-47 mmol/mol compared to HbA1c < 42 mmol/mol (reference group) was 2.10 (1.31-3.37, p = 0.002); and was 8.55 (4.58-15.99, p < 0.001) for HbA1c ≥ 48 mmol/mol. The association between baseline HbA1c and incident PDAC attenuated with increasing duration of time of follow-up to PDAC diagnosis.
Conclusions: dysglycaemia detected by elevated HbA1c is associated with an increased risk of PDAC. The strength of the association between elevated HbA1c and incident PDAC is inversely proportional to the time from detecting dysglycaemia but remains significant for at least 60 months following HbA1c testing.
Text
cancers-15-04078
- Accepted Manuscript
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cancers-15-04078
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More information
Accepted/In Press date: 9 August 2023
e-pub ahead of print date: 13 August 2023
Additional Information:
Funding Information: this work was supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre (Grant Number IS-BRC-20004).
Keywords:
adenocarcinoma, diabetes, HbA1c, NODM, pancreatic, PDAC, T3cDM
Identifiers
Local EPrints ID: 481260
URI: http://eprints.soton.ac.uk/id/eprint/481260
ISSN: 2072-6694
PURE UUID: a8530e27-1de5-4db5-8bc3-4a81500457a8
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Date deposited: 21 Aug 2023 16:58
Last modified: 18 Mar 2024 02:50
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Contributors
Author:
Declan McDonnell
Author:
Adrian W.E. Cheang
Author:
Sam Wilding
Author:
Sarah H. Wild
Author:
Adam E. Frampton
Author:
Zaed Z. Hamady
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