Body mass index and cancer mortality in patients with incident type 2 diabetes: A population‐based study of adults in England

Alam, Nasra N, Wright, Alison K, Rutter, Martin K, Buchan, Iain ORCID: 0000-0003-3392-1650, Ashcroft, Darren M, Sperrin, Matthew and Renehan, Andrew G (2021) Body mass index and cancer mortality in patients with incident type 2 diabetes: A population‐based study of adults in England. Diabetes, Obesity and Metabolism, 24 (4). pp. 620-630.

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Official URL: http://dx.doi.org/10.1111/dom.14614

Abstract

<h4>Aims</h4>We evaluated the relationship between body mass index (BMI) and cancer mortality in incident type 2 diabetes.<h4>Methods</h4>We used the Clinical Practice Research Datalink GOLD (1998-2015), linked with the Office of National Statistics mortalities, and derived an incident type 2 diabetes cohort (N = 176 886; aged 30-85 years). We determined BMI ±12 months diabetes diagnosis. The primary outcome was cancer mortality, categorized into deaths from obesity-related cancers (ORCs) and non-ORCs. Secondary outcomes were site-specific cancer mortality and main causes of deaths [cancer, cardiovascular disease (CVD), non-cancer non-CVD]. We developed gender-specific Cox models and expressed risk as hazard ratios and 95% confidence intervals, stratified by smoking status.<h4>Results</h4>With 886 850 person-years follow-up, 7593 cancer deaths occurred. Among women who never smoked, there were positive associations between BMI and deaths from endometrial (hazard ratios per 5 kg/m<sup>2</sup> : 1.43; 95% confidence interval 1.26-1.61). Among men, associations between BMI and ORC mortality were inverse but attenuated towards null among never smokers and excluding deaths in the first 2 years. In men, the proportion of CVD deaths increased from 36.8% in BMI category 22.5 to 24.9 kg/m<sup>2</sup> to 43.6% in BMI category ≥40 kg/m<sup>2</sup> (p < .001).<h4>Conclusions</h4>We found some relationships between BMI and cancer mortality in patients with type 2 diabetes, but interpretations need to account for smoking status, reverse causality and deaths from CVD.

Item Type:	Article
Uncontrolled Keywords:	BMI, cancer, mortality, obesity, type 2 diabetes
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	28 Feb 2022 08:43
Last Modified:	18 Jan 2023 21:11
DOI:	10.1111/dom.14614
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3149514