Online citations, reference lists, and bibliographies.

Elevated HbA1c Is An Independent Predictor Of Aggressive Clinical Behavior In Patients With Colorectal Cancer: A Case-Control Study

Ali A Siddiqui, Stuart Jon Spechler, Sergio Huerta, Serag Dredar, Bertis B. Little, Byron L. Cryer
Published 2008 · Medicine
Cite This
Download PDF
Analyze on Scholarcy
Share
Aim The aim of this study was to seek an association between the control of type 2 diabetes mellitus (T2DM), as determined by hemoglobin A1c (HbA1c) levels, and the outcome of colorectal cancer (CRC). Methods We performed a retrospective review of patients with T2DM who had CRC diagnosed between 1997 and 2001. We defined well-controlled T2DM as HbA1c < 7.5% and poorly controlled T2DM as HbA1c ≥ 7.5%. A group of age- and gender-matched patients who had CRC without T2DM were used as controls. Forty clinical factors were reviewed, and those associated with poor clinical outcome in each group were examined by univariate analysis (UA) and by the maximum likelihood analysis of logistic regression to determine the independent predictors of cancer outcome. Results We identified 155 patients with T2DM and CRC, and 114 control patients who had CRC without T2DM. We found no significant differences in any clinical factor by UA between the patients with well-controlled T2DM and the patients who had CRC without T2DM. Compared to both of those patients groups, in contrast, the patients with poorly controlled T2DM had more right-sided CRCs (P = 0.04, OR = 2, 95% CI = 1–4.1), more advanced CRCs (P = 0.02, OR = 2.1, 95% CI = 1–4.4), a younger age of presentation (P = 0.05), greater use of exogenous insulin (P = 0.002), and a poorer 5-year survival (P = 0.001) by UA. Logistic regression showed that poorly controlled T2DM independently predicted the early onset of CRC, a more advanced stage at the time of presentation, poorer 5-year survival, and an increased incidence of right-sided CRCs. Conclusions In patients with T2DM who have CRC, poor glycemic control is associated with a clinically aggressive course for the cancer.
This paper references
10.1093/jnci/91.7.620
Prospective study of colorectal cancer risk in men and plasma levels of insulin-like growth factor (IGF)-I and IGF-binding protein-3.
J Ma (1999)
10.1126/science.635569
The glycosylation of hemoglobin: relevance to diabetes mellitus.
H. Franklin Bunn (1978)
10.3322/canjclin.56.2.106
Cancer statistics, 2006.
Ahmedin Jemal (2006)
Effects of calcium and pH on the mucosal damage produced by deoxycholic acid in the rat colon. Gut 27:1320–1329
JJ Rafter (1986)
10.1001/jama.282.13.1254
The relationship between cyclooxygenase-2 expression and colorectal cancer.
Katherine M. Sheehan (1999)
10.7326/0003-4819-140-11-200406010-00035
The Evolving Diabetes Burden in the United States
Michael M. Engelgau (2004)
Association of markers of insulin and glucose control with subsequent colorectal cancer risk.
Sharon H. Saydah (2003)
Glycated hemoglobin: methodologies and clinical applications.
David E. Goldstein (1986)
10.1054/bjoc.2000.1582
Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinaemia hypothesis
Tom Ivar Lund Nilsen (2001)
10.1093/jnci/91.6.542
Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women.
Frank B Hu (1999)
10.1093/ije/27.5.794
Relation of serum total cholesterol, serum triglycerides and fasting plasma glucose to colorectal carcinoma in situ.
Kouich Yamada (1998)
10.1016/S0889-8553(02)00057-2
Modifiable risk factors for colon cancer.
Edward L. Giovannucci (2002)
10.1093/jn/131.11.3109S
Insulin, insulin-like growth factors and colon cancer: a review of the evidence.
Edward L. Giovannucci (2001)
Serum lipids and adenomas of the left colon and rectum.
Colin Leonard Bird (1996)
10.1093/carcin/14.4.777
Sucrose enhancement of the early steps of colon carcinogenesis in mice.
Dennis H Stamp (1993)
10.2337/diacare.15.7.815
Onset of NIDDM occurs at Least 4–7 yr Before Clinical Diagnosis
Maureen I. Harris (1992)
10.1093/jnci/94.13.972
Insulin, insulin-like growth factor-I (IGF-I), IGF binding proteins, their biologic interactions, and colorectal cancer.
Manjinder S. Sandhu (2002)
10.1172/JCI117871
Apoptosis induced by an anti-epidermal growth factor receptor monoclonal antibody in a human colorectal carcinoma cell line and its delay by insulin.
Xinyuan Wu (1995)
10.1111/j.1572-0241.2006.00725.x
Clinically Confirmed Type 2 Diabetes Mellitus and Colorectal Cancer Risk: A Population-Based, Retrospective Cohort Study
Paul John Limburg (2006)
10.1136/gut.45.1.45
Human right and left colon differ in epithelial cell apoptosis and in expression of Bak, a pro-apoptotic Bcl-2 homologue
Lawrence U. Liu (1999)
10.1200/JCO.2003.07.125
Impact of diabetes mellitus on outcomes in patients with colon cancer.
Jeffrey A. Meyerhardt (2003)
10.1093/oxfordjournals.aje.a009534
Colorectal cancer: another complication of diabetes mellitus?
J. C. Ogilvie Will (1998)
10.1007/BF00052777
Insulin and colon cancer
Edward Giovannucci (2004)
10.1093/jnci/92.19.1592
Serum C-peptide, insulin-like growth factor (IGF)-I, IGF-binding proteins, and colorectal cancer risk in women.
Rudolf J. Kaaks (2000)
Preliminary communication: glycated hemoglobin, diabetes, and incident colorectal cancer in men and women: a prospective analysis from the European prospective investigation into cancer-Norfolk study.
Kay-Tee Khaw (2004)
Insulin promotion of colon tumors in rats.
Thien Toan Tran (1996)
10.1053/j.gastro.2004.07.011
Insulin therapy and colorectal cancer risk among type 2 diabetes mellitus patients.
Yu-Xiao Yang (2004)
Markers of insulin resistance and colorectal cancer mortality.
Maurizio Trevisan (2001)
10.1093/carcin/6.7.1063
Toxicity of orally administered fat to the colonic epithelium of mice.
Ranjana P. Bird (1985)
10.1136/gut.27.11.1320
Effects of calcium and pH on the mucosal damage produced by deoxycholic acid in the rat colon.
Joseph James Rafter (1986)
10.1016/S0140-6736(04)16044-3
Insulin-like growth factor (IGF)-I, IGF binding protein-3, and cancer risk: systematic review and meta-regression analysis
Andrew G Renehan (2004)
10.1080/01635589709514543
Insulin injections promote the growth of aberrant crypt foci in the colon of rats.
Denis E. Corpet (1997)
East meets West: a comparison of eastern block/western aeromedical practices.
Terence J. Lyons (1997)
Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk?
Gail E. McKeown-Eyssen (1994)
10.1046/j.1525-1497.2000.08024.x
Revisiting the oral glucose tolerance test criterion for the diagnosis of diabetes
Mayer B Davidson (2007)
Serum insulin levels and the prevalence of adenomatous and hyperplastic polyps in the proximal colon
吉田 功 (2007)
10.1093/jnci/djh082
A prospective study of plasma C-peptide and colorectal cancer risk in men.
Jing Ma (2004)
10.1016/0304-3835(88)90023-7
Proliferative activity of rectal mucosa and soluble fecal bile acids in patients with normal colons and in patients with colonic polyps or cancer.
J. Stadler (1988)
Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group.
Robert C. Turner (1998)
Insulin and insulin-like growth factor 1 stimulate proliferation of metastatic variants of colon carcinoma
M Koenuma (1989)
10.1111/j.1349-7006.1989.tb02244.x
Insulin and Insulin‐like Growth Factor 1 Stimulate Proliferation of Metastatic Variants of Colon Carcinoma 26
Mitsuo Koenuma (1989)
10.1093/aje/kwh161
Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults.
Steven Scott Coughlin (2004)
10.1016/S0009-9120(98)00019-8
The place of electron spin resonance methods in the detection of oxidative stress in type 2 diabetes with poor glycemic control.
Marie-Christine Delmas-Beauvieux (1998)
10.1158/1055-9965.EPI-04-0661
A Prospective Study of C-Peptide, Insulin-like Growth Factor-I, Insulin-like Growth Factor Binding Protein-1, and the Risk of Colorectal Cancer in Women
Esther Wei (2005)
10.1503/cmaj.1031921
Association of socioeconomic status and receipt of colorectal cancer investigations: a population-based retrospective cohort study
Sheldon M. Singh (2004)
10.1093/jnci/91.13.1147
Increased blood glucose and insulin, body size, and incident colorectal cancer.
Robert E. Schoen (1999)
10.1146/annurev.publhealth.26.021304.144532
Primary prevention of diabetes: what can be done and how much can be prevented?
Matthias B. Schulze (2005)
10.2337/diacare.27.suppl_2.B10
Who has diabetes? Best estimates of diabetes prevalence in the Department of Veterans Affairs based on computerized patient data.
Donald Miller (2004)
10.1016/j.accreview.2004.12.134
Dietary patterns, meat intake, and the risk of type 2 diabetes in women
Teresa T Fung (2005)



This paper is referenced by
10.4143/crt.2016.128
Association between Metformin Use and Survival in Nonmetastatic Rectal Cancer Treated with a Curative Resection: A Nationwide Population Study
Young-Jun Ki (2017)
10.20524/aog.2016.0060
Impact of glycemic control on colonoscopy outcomes: bowel preparation and polyp detection
Manhal Izzy (2016)
10.1038/bjc.2014.150
Does cancer risk increase with HbA1c, independent of diabetes?
Joe De Beer (2014)
10.4158/EP12128.OR
Cancer with diabetes: prevalence, metabolic control, and survival in an academic oncology practice.
Nina J. Karlin (2012)
10.1007/s00404-012-2455-7
Hemoglobin A1c and the relationship to stage and grade of endometrial cancer
Erin Elizabeth Stevens (2012)
10.1038/bjc.2014.68
Diabetes and prognosis in older persons with colorectal cancer
Juhua Luo (2014)
10.1007/s13668-016-0157-7
The Association Between Adiposity and Survival in Patients with Colorectal Cancer
L Durko (2016)
INTERNATIONAL HEALTH NEWS
William R. Ware (2010)
10.1016/j.jss.2019.02.043
Glucose to Lymphocyte Ratio as a Prognostic Marker in Patients With Resected pT2 Gallbladder Cancer.
Jonathán E. Pereira Navarro (2019)
10.1007/s10552-011-9875-8
Impact of comorbidity and healthcare utilization on colorectal cancer stage at diagnosis: literature review
Mark Corkum (2011)
Survival Analysis and Prognostic Factors for Colorectal Cancer Patients in Malaysia.
Muhammad Radzi Abu Hassan (2016)
10.33915/etd.669
Impact of Diabetes on Colorectal Cancer Outcomes
Neel A. Shah (2012)
10.4103/apjon.apjon_22_17
Chemotherapy and Glycemic Control in Patients with Type 2 Diabetes and Cancer: A Comparative Case Analysis
Denise Soltow Hershey (2017)
10.1158/1055-9965.EPI-16-0312
Metformin, Diabetes, and Survival among U.S. Veterans with Colorectal Cancer
Jessica K. Paulus (2016)
10.4155/FSOA-2016-0020
Risk of hospitalization in patients with diabetes mellitus who have solid-organ malignancy
Nina J. Karlin (2016)
10.2169/internalmedicine.0204-17
An Autopsy Case of Pulmonary Tumor Thrombotic Microangiopathy Due to Rapidly Progressing Colon Cancer in a Patient with Type 2 Diabetes
H Ohguchi (2018)
10.14740/jocmr2607w
An Elevated HbA1c Level Is Associated With Short-Term Adverse Outcomes in Patients With Gastrointestinal Cancer and Type 2 Diabetes Mellitus
Yingchun Huang (2017)
10.3346/jkms.2016.31.9.1464
Impact of Glycemic Control and Metformin Use on the Recurrence and Progression of Non-Muscle Invasive Bladder Cancer in Patients with Diabetes Mellitus
Ji Hoon Ahn (2016)
Endometrium Kanserinde Kötü Glisemik Kontrolün Evre ve Grade Üzerine Etkisi
Emre Ozgu (2016)
10.1016/j.diabet.2013.12.007
Colorectal cancer, diabetes and survival: epidemiological insights.
M.M.J. Zanders (2014)
10.1007/s11764-010-0141-y
The impact of diabetes process and outcome quality measures on overall survival in patients with co-morbid colorectal cancer
Elizabeth Y Chiao (2010)
10.1002/ijc.30683
Dietary glycemic and insulin scores and colorectal cancer survival by tumor molecular biomarkers
NaNa Keum (2017)
10.1096/fj.201900396rr
Unmasking the interplay between mTOR and Nox4: novel insights into the mechanism connecting diabetes and cancer.
Fatima Mroueh (2019)
10.1016/j.jdiacomp.2011.11.003
Diabetes and the risk for colorectal cancer.
Michael Erbach (2012)
10.1002/mc.20720
Energy balance modulates colon tumor growth: Interactive roles of insulin and estrogen.
Elizabeth A. Rondini (2011)
10.1007/s11605-012-1978-3
Short-term Outcomes in Obese Patients after Colectomy for Adenocarcinoma at a Bariatric Center
Zubin M. Bamboat (2012)
Integrative model of lifestyle effects on cancer via the HbA1c biomarker
De Beer (2014)
10.3748/WJG.V16.I24.3025
Glycated hemoglobin and antidiabetic strategies as risk factors for hepatocellular carcinoma.
Valter Donadon (2010)
10.3892/mco.2018.1554
Metformin and aspirin treatment could lead to an improved survival rate for Type 2 diabetic patients with stage II and III colorectal adenocarcinoma relative to non-diabetic patients.
Ariella De Monte (2018)
10.3748/wjg.v22.i45.9984
Prognostic value of glycated hemoglobin in colorectal cancer
Patrizia Ferroni (2016)
10.3747/co.23.2809
A retrospective study on the role of diabetes and metformin in colorectal cancer disease survival.
Ravi Ramjeesingh (2016)
10.2217/DMT.15.36
Hyperglycemia among hospitalized cancer patients with coexisting diabetes mellitus
Nina J. Karlin (2015)
See more
Semantic Scholar Logo Some data provided by SemanticScholar