臺大醫院;臺大醫院-內科部;臺大醫院雲林分院;臺大醫學院;Hsu, Chih-NengChih-NengHsuCHIA-HSUIN CHANGLin, Yu-ShengYu-ShengLinJOU-WEI LINCaffrey, James LJames LCaffrey2014-02-142018-07-112014-02-142018-07-112013http://ntur.lib.ntu.edu.tw//handle/246246/259078http://ntur.lib.ntu.edu.tw/bitstream/246246/259078/1/index.htmlBackground: Known associations between diabetes and cancer could logically be attributed to hyperglycemia, hypersecretion of insulin, and/or insulin resistance. This study examined the relationship between initial glycemic biomarkers among men and women with impaired fasting glucose or undiagnosed diabetes and cancer mortality during follow up. Methods: The cohort included subjects aged 40 years and above from the Third National Health and Nutrition Examination Survey (NHANES III) with fasted serum glucose >100 mg/dl without the aid of pharmaceutical intervention (insulin or oral hypoglycemics). Cancer mortality was obtained from the NHANES III-linked follow-up database (up to December 31, 2006). A Cox regression model was applied to test for the associations between cancer mortality and fasting serum glucose, insulin, glycosylated hemoglobin (HbA1c), C-peptide, insulin like growth factor (IGF-1), IGF binding protein 3 (IGFBP3) and estimated insulin resistance. Results: A total of 158 and 100 cancer deaths were recorded respectively from 1,348 men and 1,161 women during the mean 134-month follow-up. After adjusting for the effect of age and smoking in women, all-cause cancer deaths (HR: 1.96 per pmol/ml, 95% CI: 1.02-3.77) and lung cancer deaths (HR: 2.65 per pmol/ml, 95% CI: 1.31-5.36) were specifically associated with serum C-peptide concentrations. Similar associations in men were not statistically significant. Serum glucose, HbA1c, IGF-1, IGFBP3 and HOMA were not independently related to long-term cancer mortality. Conclusion: C-peptide analyses suggest a modest association with both all-cause and lung cancer mortality in women but not in men. Further studies will be required to explore the mechanisms.110 bytestext/html[SDGs]SDG3biological marker; C peptide; glucose; hemoglobin A1c; insulin; somatomedin binding protein 3; somatomedin C; adult; age; aged; article; cancer mortality; controlled study; diabetes mellitus; disease association; female; follow up; glucose blood level; hemoglobin blood level; human; impaired glucose tolerance; insulin blood level; insulin release; insulin resistance; lung cancer; major clinical study; male; protein blood level; risk assessment; sex difference; smoking; Adult; Aged; Biological Markers; C-Peptide; Cohort Studies; Diabetes Complications; Diabetes Mellitus, Type 2; Female; Follow-Up Studies; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasms; Prediabetic State; Prognosis; Risk Factors; Smoking; Survival Ratejournal article10.1371/journal.pone.0055625http://ntur.lib.ntu.edu.tw/bitstream/246246/259078/1/index.html