Elevated Glycated Haemoglobin (HbA1c) Is Associated with an Increased Risk of Pancreatic Ductal Adenocarcinoma: A UK Biobank Cohort Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Identification of Incident PDAC Participants and the Main Exposures
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Participant Characteristics | No Diabetes Mellitus on Enrolment | Diabetes Mellitus on Enrolment | Total | p Value |
---|---|---|---|---|
Number of Participants, n (%) | 473,264 (94.7%) | 26,540 (5.3%) | 499,804 | <0.001 b |
Age at attendance (years) a | 56.4 (8.1) | 59.5 (7.2) | 56.5 (8.1) | <0.001 b |
Men, n (%) | 211,583 (44.7%) | 16,095 (60.6%) | 227,678 (45.6%) | <0.001 c |
Glycated haemoglobin (HbA1c) category (mmol/mol), n (%) | <0.001 c | |||
<42 mmol/mol | 420,780 (95.6%) | 5208 (21.3%) | 425,997 (91.7%) | |
42–47 mmol/mol | 15,852 (3.6%) | 5186 (21.2%) | 21,038 (4.5%) | |
≥48 mmol/mol | 3360 (0.8%) | 14,038 (57.5%) | 17,398 (3.8%) | |
Body mass index (BMI) a | 27.2 (4.6) | 31.3 (5.9) | 27.4 (4.8) | <0.001 b |
Body mass index (BMI) category, n (%) | <0.001 c | |||
Underweight d | 2574 (0.6%) | 36 (0.1%) | 2610 (0.5%) | |
Normal d | 156,970 (33.3%) | 2838 (10.8%) | 159,808 (32.1%) | |
Overweight d | 202,425 (43.0%) | 8961 (34.2%) | 211,386 (42.5%) | |
Obese d | 108,990 (23.1%) | 14,381 (54.9%) | 123,371 (24.8%) |
Variable | Diabetes Mellitus on Enrolment | Participants | Incident PDAC (n, %) | Incidence (per 1000 Person-Years) | Multivariable Hazard Ratio (95% CI) b | p Value | Proportional Hazards Assumption |
---|---|---|---|---|---|---|---|
Glycated haemoglobin (HbA1c) | |||||||
<42 mmol/mol | No | 420,789 | 869 (91.1%) | 0.17 | 1 (Reference) (N/A c) | <0.001 | |
42–47 mmol/mol | 15,872 | 66 (6.9%) | 0.3 | 1.39 (1.07–1.81) (N/A c) | 0.015 | ||
≥48 mmol/mol | 3360 | 19 (2.0%) | 0.33 | 2.17 (1.37–3.44) (N/A c) | 0.001 | ||
<42 mmol/mol | Yes | 5208 | 16 (13.8%) | 0.28 | 1 (Reference) | 0.2263 | |
42–47 mmol/mol | 5186 | 22 (19.0%) | 0.39 | 1.28 (0.66–2.46) | 0.463 | ||
≥48 mmol/mol | 14,038 | 78 (67.2%) | 0.51 | 1.95 (1.12–3.37) | 0.017 |
Time Since Enrolment in UKBB | Glycaemic Category at Enrolment and Cox Proportional Hazard Ratio for Incident PDAC | |||||||
---|---|---|---|---|---|---|---|---|
<42 mmol/mol | 42–47 mmol/mol | |||||||
Total at Risk During Time Interval (n) | Incident PDAC during Time Interval (n) | Hazard Ratio (95% CI) b | p Value | Total at Risk During Time Interval (n) | Incident PDAC during Time Interval (n) | Hazard Ratio (95% CI) b | p Value | |
12 months | 420,707 | 36 | 1 (Reference) | 15,840 | 9 | 2.10 (1.31–3.37) | 0.002 | |
24 months | 419,980 | 50 | 1 (Reference) | 15,752 | 3 | 1.92 (1.29–2.88) | 0.001 | |
36 months | 418,816 | 66 | 1 (Reference) | 15,645 | 5 | 1.76 (1.26–2.49) | 0.001 | |
48 months | 417,318 | 71 | 1 (Reference) | 15,532 | 9 | 1.62 (1.21–2.17) | 0.001 | |
60 months | 415,620 | 78 | 1 (Reference) | 15,394 | 5 | 1.49 (1.14–1.94) | 0.004 | |
72 months | 413,705 | 86 | 1 (Reference) | 15,260 | 5 | 1.36 (1.04–1.78) | 0.024 | |
84 months | 411,526 | 103 | 1 (Reference) | 15,118 | 7 | 1.25 (0.93–1.68) | 0.141 |
Time Since Enrolment in UKBB | Glycaemic Category at Enrolment and Cox Proportional Hazard Ratio for Incident PDAC | |||||||
---|---|---|---|---|---|---|---|---|
<42 mmol/mol | ≥48 mmol/mol | |||||||
Total at Risk During Time Interval (n) | Incident PDAC during Time Interval (n) | Hazard Ratio (95% CI) b | p Value | Total at Risk during Time Interval (n) | Incident PDAC during Time Interval (n) | Hazard Ratio (95% CI) b | p Value | |
12 months | 420,707 | 36 | 1 (Reference) | 3356 | 6 | 8.55 (4.58–15.99) | <0.001 | |
24 months | 419,980 | 50 | 1 (Reference) | 3330 | 2 | 5.80 (3.45–9.75) | <0.001 | |
36 months | 418,816 | 66 | 1 (Reference) | 3312 | 3 | 3.94 (2.46–6.29) | <0.001 | |
48 months | 417,318 | 71 | 1 (Reference) | 3290 | 3 | 2.67 (1.63–4.37) | <0.001 | |
60 months | 415,620 | 78 | 1 (Reference) | 3265 | 1 | 1.81 (1.01–3.24) | 0.045 | |
72 months | 413,705 | 86 | 1 (Reference) | 3232 | 1 | 1.23 (0.60–2.50) | 0.568 | |
84 months | 411,526 | 103 | 1 (Reference) | 3204 | 1 | 0.82 (0.35–1.98) | 0.681 |
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Share and Cite
McDonnell, D.; Cheang, A.W.E.; Wilding, S.; Wild, S.H.; Frampton, A.E.; Byrne, C.D.; Hamady, Z.Z. Elevated Glycated Haemoglobin (HbA1c) Is Associated with an Increased Risk of Pancreatic Ductal Adenocarcinoma: A UK Biobank Cohort Study. Cancers 2023, 15, 4078. https://doi.org/10.3390/cancers15164078
McDonnell D, Cheang AWE, Wilding S, Wild SH, Frampton AE, Byrne CD, Hamady ZZ. Elevated Glycated Haemoglobin (HbA1c) Is Associated with an Increased Risk of Pancreatic Ductal Adenocarcinoma: A UK Biobank Cohort Study. Cancers. 2023; 15(16):4078. https://doi.org/10.3390/cancers15164078
Chicago/Turabian StyleMcDonnell, Declan, Adrian W. E. Cheang, Sam Wilding, Sarah H. Wild, Adam E. Frampton, Christopher D. Byrne, and Zaed Z. Hamady. 2023. "Elevated Glycated Haemoglobin (HbA1c) Is Associated with an Increased Risk of Pancreatic Ductal Adenocarcinoma: A UK Biobank Cohort Study" Cancers 15, no. 16: 4078. https://doi.org/10.3390/cancers15164078