Abnormal glucose metabolism and pancreatic cancer mortality

Context Previous studies reported an increased risk of pancreatic cancer am ong persons with diabetes. Few data exist, however, on the association of p ostload plasma glucose concentration with pancreatic cancer, which could pr ovide insight into the role of abnormal glucose metabolism in the etiology of pancreatic cancer. Objective To determine the independent association between postload plasma glucose concentration and risk of pancreatic cancer mortality among persons without self-reported diabetes. Design Prospective cohort study. Setting and Participants Employees of 84 Chicago-area organizations, with a n average age of 40 years at baseline, were screened from 1963 to 1973 and followed up for an average of 25 years. A total of 96 men and 43 women died of pancreatic cancer among 20475 men and 15 183 women, respectively. Main Outcome Measures Relationship of pancreatic cancer mortality with post load plasma glucose levels. Results Compared with a postload plasma glucose level of 6.6 mmol/L (119 mg / dL) or less and after adjusting for age, race, cigarette smoking, and bod y mass index, the relative risks (95% confidence intervals) of pancreatic c ancer mortality were 1.65 (1.05-2.60) for postload plasma glucose levels be tween 6.7 (120) and 8.8 (159) mmol/L (mg/dL); 1.60 (0.95-2.70) for levels b etween 8.9 (160) and 11.0 (199); and 2.15 (1.22-3.80) for levels of 11.1 (2 00) or more; P far trend = .01. An association appeared to be stronger for men than women. Estimates were only slightly lower after excluding 11 men a nd 2 women who died of pancreatic cancer during the first 5 years of follow up. In men only, higher body mass index and serum uric acid concentration a lso were independently associated with an elevated risk of pancreatic cance r mortality. Conclusion These results suggest that factors associated with abnormal gluc ose metabolism may play an important role in the etiology of pancreatic can cer.