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- Title
Haemoglobin A1c and serum glucose levels and risk of gastric cancer: a systematic review and meta-analysis.
- Authors
Zheng, Jiaojiao; Gao, Yunhe; Xie, Shao-Hua; Santoni, Giola; Lagergren, Jesper
- Abstract
<bold>Background: </bold>This systematic review and meta-analysis examined associations between serum levels of haemoglobin A1c (HbA1c) and glucose and the risk of gastric cancer.<bold>Methods: </bold>MEDLINE, Embase, and Cochrane Library were searched for studies examining associations between serum levels of HbA1c or glucose and the risk of gastric cancer. Inclusion of studies, quality assessment, and data extraction were conducted independently by two authors. Pooled hazard ratios (HR) with 95% confidence intervals (CI) were synthesised using random-effects models. Cochran's Q test and I2 statistic were used to assess heterogeneity.<bold>Results: </bold>Among 3473 identified studies, 12 were included. Of these, 5 studies examined HbA1c levels and 7 studies examined serum glucose levels. Serum HbA1c levels >6% were associated with an increased risk of gastric cancer (HR 1.36, 95% CI 1.06-1.74). When compared with the lowest glucose categories, the highest glucose categories were associated with a borderline increased risk of gastric cancer (HR 1.11, 95% CI 0.98-1.26). In subgroup analyses, studies that adjusted for Helicobacter pylori infection indicated stronger associations between elevated HbA1c levels and gastric cancer (HR 2.08, 95% CI 1.46-2.98) than those without such adjustment (HR 1.10, 95% CI 0.91-1.32).<bold>Conclusions: </bold>Long-standing poor glycaemic control may increase the risk of gastric cancer.<bold>Registration Number: </bold>PROSPERO CRD42020157453.
- Subjects
STOMACH tumors; RESEARCH; HELICOBACTER pylori; META-analysis; RESEARCH methodology; SYSTEMATIC reviews; EVALUATION research; COMPARATIVE studies; RESEARCH funding; GLUCOSE; HELICOBACTER diseases; DISEASE complications
- Publication
British Journal of Cancer, 2022, Vol 126, Issue 6, p1100
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-021-01693-3