Association Of Diabetes Mellitus And Pancreatic Cancer

Objective: Diabetes mellitus is widely considered associated with an increased risk of pancreatic cancer,however,diabetes mellitus is a cause or a effect is still controversial,the purpose of our study was to assess the relationship between diabetes mellitus and risk of pancreatic cancer,to provide the clues for the early diagnosis of pancreatic cancer.Methods: A literature search was performed by searching electronic databases of Pubmed?Embase and the Cochrane Library.All documents that associate with diabetes mellitus and pancreatic cancer published before January 1,2019 were searched.Two investigators evaluated the quality of the eligible studies according to the Newcastle-Ottawa Scale(NOS)and extracted necessary data independently.The details of characteristics of the subjects and results of the studies were reviewed and analyzed by using Stata software,version 14.0.Heterogeneity test were assessed to the studies.According to the result of heterogeneity test,A random effects model or a fixed effect model was used to meta analysis.Odds Ratios(ORs)and corresponding 95% confidence intervals(CIs)were calculated to analyze the relationship between the diabetes and the development of PC.Finally,we used Begg's test and Egger's test to assess publication bias of the included studies,also,sensitivity analysis was performed to investigate the influence of a single study on the overall meta-analysis estimate.Results: 1.Twenty-eight case-control studies involving a total number of 58491 cases(7702 pancreatic cancer cases and 10186 controls)were included in this meta-analysis,The overall summary estimate for the relationship between the diabetes and pancreatic cancer was 3.00(95% CI,2.59~3.48).The difference is of significance in statistics science(Z=14.49.P?0.001).2.The hierarchical analysis of diabetic duration indicated the risk of developing pancreatic cancer was inversely associated with the duration of diabetes,patients with diabetes mellitus diagnosed<2 years before cancer detection had the highest risk of pancreatic cancer.OR(95%CI)is 4.93(3.53~6.88).Individuals who had diabetes <2 years had a 2.3~2.8 folds higher risk of developing pancreatic cancer than individuals who had diabetes for 2~5 years(OR,2.56;95%CI,2.13~3.08)or 5~10 years(OR,2.05;95% CI,1.66~2.53),the P values of hypothetical test were less than 0.001,there were statistical significance in statistics science.Our results were stable and there was no evidence of publication bias in all of the included studies.Conclusion: Diabetes mellitus was significantly related to the risk of pancreatic cancer.New-onset diabetes is probably a early manifestation of pancreatic cancer and Long-term diabetes is a risk factor of pancreatic cancer.