1000/1000
Hot
Most Recent
Diabetes patients have an increased risk of gastric cancer (GCa) and incidence of second primary malignancy diagnosed after GCa is significantly higher in diabetes patients. Diabetes patients with GCa may have more complications after gastrectomy or chemotherapy and they may have a poorer prognosis than patients with GCa but without diabetes mellitus. However, glycemic control may improve in the diabetes patients with GCa after receiving gastrectomy, especially after procedures that bypass the duodenum and proximal jejunum, such as Roux-en-Y gastric bypass or Billroth II reconstruction. The potential links between diabetes mellitus and GCa may involve the interactions with shared risk factors (e.g., obesity, hyperglycemia, hyperinsulinemia, insulin resistance, high salt intake, smoking, etc.), Helicobacter pylori (HP) infection, medications (e.g., insulin, metformin, statins, aspirin, proton pump inhibitors, antibiotics, etc.) and comorbidities (e.g., hypertension, dyslipidemia, vascular complications, heart failure, renal failure, etc.)
Potential Mechanisms | Explanations |
---|---|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Authors | Year Published | Studies Included in Meta-Analysis | Outcome of Gastric Cancer | Estimated Relative Risk (95% Confidence Interval) | References |
---|---|---|---|---|---|
Riskof gastric cancer associated withdiabetes mellitus | |||||
Ge et al. | 2011 | 4 case-control and 17 cohort studies | Incidence and mortality | All: 1.09 (0.98–1.22) Women: 1.18 (1.01–1.39) Men: 1.04 (0.94–1.15) |
[61] |
Tian et al. | 2012 | 7 case-control and 14 cohort studies | Incidence | All: 1.11 (1.00–1.24) Case-control: 1.04 (0.84–1.29) Cohort: 1.14 (1.01–1.30) |
[62] |
6 studies from Asia | Incidence | Asian: 1.19 (1.07–1.32) | |||
7 studies | Mortality | 1.29 (1.04–1.59) | |||
Shimoyama | 2013 | 2 case-control and 10 cohort studies | Incidence | All: 1.41 (1.10–1.81) | [63] |
6 studies | Men: 1.24 (1.08–1.43) Women: 1.90 (1.27–2.85) |
||||
5 studies | Asian: 1.77 (1.38–2.26) | ||||
6 studies | White: 1.23 (0.90–1.68) | ||||
Yoon et al. | 2013 | 6 case-control and 11 cohort studies | Incidence | All: 1.19 (1.08–1.31) Men: 1.10 (0.97–1.24) Women: 1.24 (1.01–1.52) Asian: 1.19 (1.02–1.38) Western: 1.18 (1.03–1.36) |
[64] |
Miao et al. | 2017 | 15 cohort studies | Incidence | 1.10 (0.94–1.29) | [65] |
11 cohort studies | Incidence | Men: 1.00 (0.90–1.11) | |||
10 cohort studies | Incidence | Women: 1.07 (0.93–1.22) | |||
9 cohort studies | Mortality | All: 1.28 (0.93–1.76) Men < 55 years old: 1.16 (1.05–1.29) Western women: 1.31 (1.09–1.57) |
|||
Chen et al. | 2017 | 19 cohorts in Asian countries | Mortality | All: 1.08 (0.95–1.23) Men: 1.02 (0.90–1.17) Women: 1.25 (1.03–1.53) |
[57] |
Ohkuma et al. | 2018 | 27 cohort studies | Incidence and mortality | Women-to-men ratio: 1.14 (1.07–1.22) | [66] |
Fang et al. | 2018 | 21 cohort studies | Incidence and mortality | Women-to-men ratio: 1.14 (1.06–1.22) | [67] |
Effect of metformin on gastric cancer | |||||
Franciosi et al. | 2013 | 2 cohort studies | Incidence | 0.83 (0.76–0.91) | [71] |
Zhou et al. | 2017 | 7 cohort studies | Incidence | 0.763 (0.642–0.905) | [72] |
Li et al. | 2018 | 4 cohort studies | Incidence | 0.867 (0.726–1.035) | [73] |
Shuai et al. | 2020 | 11 cohort studies | Incidence | 0.790 (0.624–1.001) | [74] |
Outcomes and Prognosis | Explanations |
---|---|
|
|
|
|
|
|
|
|
|
|