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Fasting but not casual blood glucose is associated with pancreatic cancer mortality in Japanese: EPOCH-JAPAN

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Abstract

Purpose

The dose–response relationship between fasting blood glucose levels and risk of pancreatic cancer has been investigated, but the association between casual blood glucose levels and pancreatic cancer death has not been examined. We examined the association between casual and fasting blood glucose levels and death due to pancreatic cancer in Japanese.

Methods

We performed a pooled analysis of the individual Japanese including 46,387 participants aged 40–79 years from ten cohorts. Participants were classified into five groups: low normal, middle normal, high normal, prediabetes (casual blood glucose 140–199 mg/dl, or fasting blood glucose 110–125 mg/dl), and diabetes (casual blood glucose ≥200 mg/dl, fasting blood glucose ≥126 mg/dl, or anti-diabetic drug use). Low normal, middle normal, and high normal were defined according to tertiles of casual or fasting normal blood glucose levels. Hazard ratios (HRs) and 95% confidence intervals (CIs) for pancreatic cancer mortality were estimated stratifying casual and fasting blood glucose by cohort-stratified Cox proportional hazards regression analysis, with low normal (casual blood glucose <94 mg/dl, or fasting blood glucose <90 mg/dl) as a reference.

Results

Fasting blood glucose showed a dose–response relationship with pancreatic cancer mortality (p for trend = 0.005). After adjusting for covariates, HRs (95% CIs) were 2.83 (1.18–6.76) for prediabetes and 3.96 (1.56–10.08) for diabetes. However, there were no significant associations with casual blood glucose. These tendencies were observed after the exclusion of participants who were censored for the first 5 years of follow-up.

Conclusions

Fasting blood glucose is a better predictor of pancreatic cancer death than casual blood glucose.

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Abbreviations

EPOCH-JAPAN:

Evidence for Cardiovascular Prevention from Observational Cohorts in Japan

BMI:

Body mass index

ICD:

The International Classification of Diseases and Related Health Problems

HR:

Hazard ratio

CI:

Confidence interval

ANOVA:

Analysis of variance

SD:

Standard deviation.

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Acknowledgements

We are grateful to all the participants in each cohort study. We thank Mrs. Toshimi Yoshida (Shiga University of Medical Science) and Mrs. Satoko Narikawa (Keio University) for expert clerical assistance.

Author contributions

HU, TO, and KM conceived and designed the pooling project. YM constructed the EPOCH-JAPAN database. MN and AT contributed to the design of the study. MN, YM, and ST participated in data analysis. MN and AT participated in the writing of the manuscript. All authors participated in the critical revision of the manuscript and approved the final version of the report for submission.

Funding

This research was supported by a grant–in–aid from the Ministry of Health, Labour and Welfare, Health and Labor Sciences research grants, Japan (Research on Health Services: H17–Kenkou–007; Comprehensive Research on Cardiovascular Disease and Life–Related Disease: H18–Junkankitou[Seishuu]–Ippan–012; Comprehensive Research on Cardiovascular Disease and Life–Related Disease: H19–Junkankitou [Seishuu]–Ippan–012; Comprehensive Research on Cardiovascular and Life–Style Related Diseases: H20–Junkankitou [Seishuu]–Ippan–013; Comprehensive Research on Cardiovascular and Life–Style Related Diseases: H23–Junkankitou [Seishuu]–Ippan–005); an Intramural Research Fund (22-4-5) for Cardiovascular Diseases of National Cerebral and Cardiovascular Center; and Comprehensive Research on Cardiovascular and Life-Style Related Diseases (H26-Junkankitou [Seisaku]-Ippan-001).

Author information

Authors and Affiliations

  1. Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8573, Japan

    Masato Nagai

  2. Graduate School of Medicine, Tohoku University, Sendai, Japan

    Masato Nagai

  3. Department of Medical Statistics, Toho University School of Medicine, Tokyo, Japan

    Yoshitaka Murakami

  4. Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Akiko Tamakoshi & Shigekazu Ukawa

  5. Departments of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yutaka Kiyohara

  6. Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan

    Michiko Yamada

  7. Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan

    Takumi Hirata

  8. Department of Medical Statistics, Shiga University of Medical Science, Otsu, Japan

    Sachiko Tanaka

  9. Department of Public Health, Shiga University of Medical Science, Otsu, Japan

    Katsuyuki Miura & Hirotsugu Ueshima

  10. Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan

    Katsuyuki Miura & Hirotsugu Ueshima

  11. Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan

    Tomonori Okamura

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  1. Masato Nagai
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  2. Yoshitaka Murakami
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  7. Takumi Hirata
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  10. Hirotsugu Ueshima
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Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN) Research Group

Corresponding author

Correspondence to Masato Nagai.

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Conflict of interest

The authors declare no conflict of interest associated with this manuscript.

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Appendix

Appendix

The Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH–JAPAN) Research Group is composed of the following investigators. Chairperson: Hirotsugu Ueshima (Shiga University of Medical Science); Co–Chairperson: Tomonori Okamura (Keio University);

Executive committee: Hirotsugu Ueshima (Shiga University of Medical Science), Yutaka Imai (Tohoku University Graduate School of Pharmaceutical Sciences), Takayoshi Ohkubo (Teikyo University School of Medicine), Fujiko Irie (Ibaraki Prefecture), Hiroyasu Iso, Akihiko Kitamura (Osaka University Graduate School of Medicine), Yutaka Kiyohara (Kyushu University Graduate School of Medicine), Katsuyuki Miura (Shiga University of Medical Science), Yoshitaka Murakami (Toho University), Hideaki Nakagawa (Kanazawa Medical University), Takeo Nakayama (Kyoto University School of Public Health), Akira Okayama (Research Institute of Strategy for Prevention), Toshimi Sairenchi (Dokkyo Medical University), Shigeyuki Saitoh (Sapporo Medical University), Kiyomi Sakata (Iwate Medical University), Akiko Tamakoshi (Hokkaido University Graduate School of Medicine), Ichiro Tsuji (Tohoku University Graduate School of Medicine), Michiko Yamada (Radiation Effects Research Foundation), Masahiko Kiyama (Osaka Center for Cancer and Cardiovascular Disease Prevention), Yoshihiro Miyamoto (National Cerebral and Cardiovascular Center), Shizukiyo Ishikawa (Jichi Medical University), Hiroshi Yatsuya (Fujita Health University), and Tomonori Okamura (Keio University School of Medicine).

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Nagai, M., Murakami, Y., Tamakoshi, A. et al. Fasting but not casual blood glucose is associated with pancreatic cancer mortality in Japanese: EPOCH-JAPAN. Cancer Causes Control 28, 625–633 (2017). https://doi.org/10.1007/s10552-017-0884-0

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  • DOI: https://doi.org/10.1007/s10552-017-0884-0

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