| Objective:We aimed to investigate associations between incidence risks of cancer and ischemic stroke(IS)with BMI and height among a sample of Chinese people living with newly diagnosed type 2 diabetes(T2D).Additionally,we applied a series of dose-response meta-analyses to testify the conclusions of population-based study.Methods:The data of included subjects and the standard population was extracted from the Chronic Disease Surveillance and Management System(CDSMS)of Ningbo Municipal Center for Disease Prevention and Control.The baseline sample consisted of 25,130 subjects living in Ningbo who were newly diagnosed with T2D between 01/01/2006 and 12/31/2007.Follow-up of the sample was from 01/01/2008 to 12/31/2014.Cancer and IS incidence stratified by BMI categories and quartiles of height were analyzed by using Poisson regression model with estimated effects being standardized incidence ratios(SIR;the ratio of observed to the expected number of diagnosed cases)and 95%confidence intervals(95%CI).All the data were obtained from the Chronic Disease Surveillance System(CDSS)of Ningbo Municipal Center for Disease Prevention and Control.In the dose-response meta-analyses section,an extensive literature search with no language restriction was performed in PubMed,Medline,Embase and Web of Science(published between 1985 and 2017)for prospective cohort studies focusing on the association between BMI and cancer incidence,BMI and IS incidence,height and cancer incidence and height and IS incidence,respectively.Meanwhile,we calculated the combined estimated effect(hazard ratio,HR)of included dataset,which were selected by the established inclusion and exclusion criteria.Besides,the HR of incidence at 12 different cancer sites(per-1 kg/m~2 increase in BMI and per-1cm increase in height)were quantified separately to estimate trends and combined by meta-analyses.Results:22,795 of the included subjects finished the follow-up.Of them,9,562 were males and13,233 were females,with mean age being 64.59±12.51 years and 65.59±13.02 years,respectively.A total of 2,335 subjects were lost to follow-up,of which 1,046 were males and 1,289 were females.There were no differences between demographic characteristics of those who finished follow-up and the lost.In total,1,063 newly diagnosed cancer cases were recognized during the follow-up.Compared with the general population of Ningbo,the all-cancer SIRs for subjects were 1.13(95%CI:1.00-1.38),0.62(95%CI:0.26-0.95)and 0.35(95%CI:0.03-0.71)in the normal BMI,overweight and obese group,respectively.Besides,higher subjects had higher all-cancer SIRs.For males,SIRs were 1.08(95%CI:0.88-1.27),1.44(95%CI:1.23-1.65),1.85(95%CI:1.53-2.06)and2.41(95%CI:2.05-2.78)in quartile 1(≤160 cm),quartile 2(161-165 cm),quartile 3(166-170 cm)and quartile 4(≥171 cm),respectively.For females,SIRs were 1.03(95%CI:0.72-1.35),1.24(95%CI:0.98-1.50),1.61(95%CI:1.24-2.02)and 2.01(95%CI:1.66-2.58)in quartile 1(≤155 cm),quartile2(156-160 cm),quartile 3(161-165 cm)and quartile 4(≥166 cm),respectively.Besides,1,268 IS cases were recognized during the follow-up.Compared to the general population of Ningbo,the SIRs were 2.26(95%CI:1.60-2.83),1.83(95%CI:1.21-2.24)and 1.37(95%CI:0.79-1.98)across different BMI categories in overall subjects for IS.For height categories,the SIRs in male subjects were 2.27(95%CI:1.99-2.56),2.01(95%CI:1.67-2.45),1.37(95%CI:1.05-1.68)and 0.91(95%CI:0.40-1.32)across different height categories.For females,the SIRs were 3.57(95%CI:3.14-4.01),2.96(95%CI:2.61-3.31),1.94(95%CI:1.51-2.36)and 1.71(95%CI:0.95-2.47)across different height categories.The results of dose-response meta-analyses showed that BMI was negatively associated with cancer incidence risk in both males(HR=0.98,95%CI:0.97-1.00 per-1 kg/m~2increase)and females(HR=0.99,95%CI:0.97-1.01 per-1 kg/m~2 increase)and positively associated with overall IS incidence risk(HR=1.02,95%CI:1.01-1.03 per-1 kg/m~2 increase).Height was positively associated with cancer incidence risk in both males(HR=1.03,95%CI:1.02-1.04 per-1 cm increase)and females(HR=1.02,95%CI:1.01-1.03 per-1 cm increase)and negatively associated with overall IS incidence risk(HR=0.94,95%CI:0.80-1.11 per-1 cm increase).Conclusions:In the sample of subjects living with newly diagnosed T2D,cancer and IS incidence risks might be higher than those of the general population of Ningbo.Besides,cancer incidence risk might be higher among those who were taller,but lower among those with higher BMI.While IS incidence risk might be lower in both subjects those who were taller and those who had higher BMI.However,these results were warrant to be verified in large-sample cohort studies because of several limitations of our study. |
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