Endocr Connect. 2022 Feb 1:EC-21-0546.R2. doi: 10.1530/EC-21-0546. Online ahead of print.
ABSTRACT
OBJECTIVE: The association between insulin therapy and the risk of biliary tract cancer (BTC) is uncertain, we aimed to assess this risk in type 2 diabetic patients.
METHODS: Using electronic medical data from the Shanghai Hospital Link database, 202,557 patients with type 2 diabetes (164,997 insulin never-users and 37,560 insulin ever-users) were identified in this study between January 1, 2013, and December 31, 2016, with follow-up until December 31, 2019. By propensity score matching, an ever-user was matched with a never-user. Cox proportional hazards regression analysis was used to estimate risk ratios (HRs) and 95% confidence intervals (CIs) for three subtypes of BTC (intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma (ECC), and gallbladder cancer (GBC)).
RESULTS: At a mean follow-up of 5.33 years, 143 cases of BTC were observed. The crude incidence rates (per 100,000 person-years) of ECC, ICC, and GBC in ever-users: never-users were 10.22: 3.63, 2.04: 2.04, and 8.17: 6.01, respectively. Insulin therapy was associated with an increased risk of ECC (HR, 4.10; 95% CI, 1.54-10.92; p = 0.005) compared to patients who never used insulin. No statistically significant results were observed for insulin and ICC/GBC. Consistent results were also found in the original cohort.
CONCLUSIONS: The relationship between insulin therapy and biliary tract cancer is type-specific, further studies are warranted to provide evidence on the identification of ECC risk groups among type 2 diabetic patients.
PMID:35148280 | DOI:10.1530/EC-21-0546
