Cohort profile: Risk evaluation of cancers in Chinese diabetic individuals: a longitudinal (REACTION) study (队列简介：中国糖尿病患者肿瘤发生风险的纵向研究（REACTION研究）)

• Published in: Journal of diabetes Vol. 6; no. 2; pp. 147 - 157
• Main Authors: Bi, Yufang, Lu, Jieli, Wang, Weiqing, Mu, Yiming, Zhao, Jiajun, Liu, Chao, Chen, Lulu, Shi, Lixin, Li, Qiang, Wan, Qin, Wu, Shengli, Yang, Tao, Yan, Li, Liu, Yan, Wang, Guixia, Luo, Zuojie, Tang, Xulei, Chen, Gang, Huo, Yanan, Gao, Zhengnan, Su, Qing, Ye, Zhen, Wang, Youming, Qin, Guijun, Deng, Huacong, Yu, Xuefeng, Shen, Feixia, Chen, Li, Zhao, Liebin, Zhang, Jie, Sun, Jichao, Dai, Meng, Xu, Min, Xu, Yu, Chen, Yuhong, Lai, Shenghan, Bloomgarden, Zachary T., Li, Donghui, Ning, Guang
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01-03-2014; John Wiley & Sons, Inc
• Subjects: Adult; Aged; Blood Glucose - metabolism; cancer; China - epidemiology; Comorbidity; diabetes; Diabetes Mellitus - blood; Diabetes Mellitus - epidemiology; Female; Health Status; Humans; Life Style; Lipids - blood; Longitudinal Studies; Male; Middle Aged; Neoplasms - blood; Neoplasms - epidemiology; Prediabetic State - blood; Prediabetic State - epidemiology; Prevalence; Public Health - methods; Public Health - statistics & numerical data; REACTION study; Risk Assessment - methods; Risk Assessment - statistics & numerical data; Risk Factors; 肿瘤，糖尿病，REACTION研究; China; cancer; REACTION study; 肿瘤，糖尿病，REACTION研究; diabetes
• ISSN: 1753-0393; 1753-0407
• DOI: 10.1111/1753-0407.12108

Objective
To demonstrate whether abnormal glucose metabolism (diabetes and prediabetes) is associated with increased risk for cancer in the Chinese population and to identify factors that modify the risk of cancer among individuals with abnormal glucose metabolism.
Methods
Between 2011 and 2012, 259 657 community‐dwelling adults, aged 40 years and older, were recruited from 25 centers across mainland China to participant in the baseline survey of the REACTION study, with follow‐up investigations performed 3, 5, and 10 years later. Detailed questionnaires about lifestyles, physical and biochemical measurement, bio‐samples including serum, urine, and whole blood for DNA extraction were collected for all the participants.
Results
The mean ± standard deviation (SD) age of this cohort was 57 ± 10 years. And the prevalence of pre‐existing and newly diagnosed diabetes was 10.32% and 10.57%, respectively. A total of 4511 prevalent cancer cases (988 men and 3523 women) were identified, the prevalence was 1.79. Compared to those with normal glucose metabolism, men with diabetes had a significantly lower adjusted prevalence ratio (PR) of stomach cancer (PR: 0.38, 95% CI: 0.16–0.89), and women with diabetes had significantly higher adjusted PRs of cancer of all sites (PR: 1.36, 95% CI: 1.20–1.56), and cancer of the breast (PR: 1.56, 95% CI: 1.21–2.00), the endometrium (PR: 1.58, 95% CI: 1.16–2.15), and the thyroid (PR: 1.53, 95% CI: 1.03–2.27).
Conclusion
The multi‐center REACTION study has captured a broad range of data on physical, psychological and metabolic function as well as health status, biochemical and lifestyle information in 259 657 adults from the general population across the China.
摘要
背景
评估在中国人群中糖代谢异常（糖尿病及糖尿病早期）是否与肿瘤风险增加相关，并寻找糖代谢异常人群中影响肿瘤风险的因素。
方法
2011‐2012年间，来自中国大陆地区25个研究中心的259657名年龄在40岁以上的社区居民被招募参加了REACTION研究的基线调查，并将在第3、5、10年接受随访。每位参与者接受了详细的生活方式问卷调查、体格检查及生化检测，并留取了生物样本，包括血清、尿液和抽提DNA所需的全血标本。
结果
该队列的平均年龄为57 ± 10岁。已诊断和新诊断糖尿病的患者分别占10.32%和10.57%。肿瘤患者总4511例（男性988例，女性3523例），患病率为1.79%。与糖耐量正常的人群相比，校正各类混杂因素后，男性糖尿病患者的胃癌患病比（prevalence ratio，PR）显著降低（PR：0.38，95% CI：0.16–0.89）， 女性糖尿病患者所有癌症（PR：1.36，95% CI：1.20–1.56）、乳腺癌（PR：1.56，95% CI：1.21–2.00）、子宫内膜癌（PR：1.58，95% CI：1.16–2.15）、甲状腺癌（PR：1.53，95% CI：1.03–2.27）的患病比显著增加。
结论
多中心的REACTION研究在259657例中国自然人群中收集了大量的有关体格、精神、代谢及健康状况、生化指标及和生活方式信息的数据。