Skip to main content

Advertisement

Springer Nature Link
Log in

Fasting but not casual blood glucose is associated with pancreatic cancer mortality in Japanese: EPOCH-JAPAN

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Purpose

The dose–response relationship between fasting blood glucose levels and risk of pancreatic cancer has been investigated, but the association between casual blood glucose levels and pancreatic cancer death has not been examined. We examined the association between casual and fasting blood glucose levels and death due to pancreatic cancer in Japanese.

Methods

We performed a pooled analysis of the individual Japanese including 46,387 participants aged 40–79 years from ten cohorts. Participants were classified into five groups: low normal, middle normal, high normal, prediabetes (casual blood glucose 140–199 mg/dl, or fasting blood glucose 110–125 mg/dl), and diabetes (casual blood glucose ≥200 mg/dl, fasting blood glucose ≥126 mg/dl, or anti-diabetic drug use). Low normal, middle normal, and high normal were defined according to tertiles of casual or fasting normal blood glucose levels. Hazard ratios (HRs) and 95% confidence intervals (CIs) for pancreatic cancer mortality were estimated stratifying casual and fasting blood glucose by cohort-stratified Cox proportional hazards regression analysis, with low normal (casual blood glucose <94 mg/dl, or fasting blood glucose <90 mg/dl) as a reference.

Results

Fasting blood glucose showed a dose–response relationship with pancreatic cancer mortality (p for trend = 0.005). After adjusting for covariates, HRs (95% CIs) were 2.83 (1.18–6.76) for prediabetes and 3.96 (1.56–10.08) for diabetes. However, there were no significant associations with casual blood glucose. These tendencies were observed after the exclusion of participants who were censored for the first 5 years of follow-up.

Conclusions

Fasting blood glucose is a better predictor of pancreatic cancer death than casual blood glucose.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Canada)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

EPOCH-JAPAN:

Evidence for Cardiovascular Prevention from Observational Cohorts in Japan

BMI:

Body mass index

ICD:

The International Classification of Diseases and Related Health Problems

HR:

Hazard ratio

CI:

Confidence interval

ANOVA:

Analysis of variance

SD:

Standard deviation.

References

  1. World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. AICR, Washington, DC

    Google Scholar 

  2. Cancer Information Service, National Cancer Center, Japan. http://ganjoho.jp/en/professional/statistics/table_download.html. Accessed 6 June 2016

  3. Statistics and Information Department Minister’s Secretariat, Ministry of Health, Labour and Welfare of Japan (2015) Vital statistics of Japan 2013. Health, Labour and Welfare Statistics Association, Tokyo

  4. Raimondi S, Maisonneuve P, Lowenfels AB (2009) Epidemiology of pancreatic cancer: an overview. Nat Rev Gastroenterol Hepatol 6:699–708

    Article  PubMed  Google Scholar 

  5. Monitoring of Cancer Incidence in Japan-Survival 2003–2005 Report (Center for Cancer Control and Information Services, National Cancer Center, 2013). http://ganjoho.jp/en/professional/statistics/table_download.html. Accessed 6 June 2016

  6. Ben Q, Xu M, Ning X et al (2011) Diabetes mellitus and risk of pancreatic cancer: a meta-analysis of cohort studies. Eur J Cancer 47:1928–1937

    Article  PubMed  Google Scholar 

  7. Giovannucci E, Harlan DM, Archer MC et al (2010) Diabetes and cancer: a consensus report. Diabetes Care 33:1674–1685

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kasuga M, Ueki K, Tajima N et al (2013) Report of the Japan Diabetes Society/Japanese Cancer Association Joint Committee on Diabetes and Cancer. Cancer Sci 104:965–976

    Article  CAS  PubMed  Google Scholar 

  9. Sasazuki S, Charvat H, Hara A et al (2013) Diabetes mellitus and cancer risk: pooled analysis of eight cohort studies in Japan. Cancer Sci 104:1499–1507

    Article  CAS  PubMed  Google Scholar 

  10. Liao WC, Tu YK, Wu MS, Lin JT, Wang HP, Chien KL (2015) Blood glucose concentration and risk of pancreatic cancer: systematic review and dose-response meta-analysis. BMJ 349:g7371

    Article  PubMed  Google Scholar 

  11. Ansary-Moghaddam A, Huxley R, Barzi F, et al (2006) The effect of modifiable risk factors on pancreatic cancer mortality in populations of the Asia-Pacific region. Cancer Epidemiol Biomark Prev 15:2435–2440

    Article  Google Scholar 

  12. Jee SH, Ohrr H, Sull JW, Yun JE, Ji M, Samet JM (2005) Fasting serum glucose level and cancer risk in Korean men and women. JAMA 293:194–202

    Article  CAS  PubMed  Google Scholar 

  13. Kodama K, Tojjar D, Yamada S, Toda K, Patel CJ, Butte AJ (2013) Ethnic differences in the relationship between insulin sensitivity and insulin response: a systematic review and meta-analysis. Diabetes Care 36:1789–1796

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Shai I, Jiang R, Manson JE et al (2006) Ethnicity, obesity, and risk of type 2 diabetes in women: a 20-year follow-up study. Diabetes Care 29:1585–1590

    Article  PubMed  Google Scholar 

  15. Hope C, Robertshaw A, Cheung KL, Idris I, English E (2015) Relationship between HbA1c and cancer in people with or without diabetes: a systematic review. Diabetes Med. doi:10.1111/dme.13031

    Google Scholar 

  16. Zhou J, Mo Y, Li H et al (2013) Relationship between HbA1c and continuous glucose monitoring in Chinese population: a multicenter study. PLoS ONE 8:e83827

    Article  PubMed  PubMed Central  Google Scholar 

  17. Murakami Y, Hozawa A, Okamura T, Ueshima H (2008) Relation of blood pressure and all-cause mortality in 180,000 Japanese participants: pooled analysis of 13 cohort studies. Hypertension 51:1483–1491

    Article  CAS  PubMed  Google Scholar 

  18. The Ministry of Health Labour and Welfare (2016) Mannual to fill in a death certificate (in Japanese). The Ministry of Health, Labour, and Welfare. http://www.mhlw.go.jp/toukei/manual/. Accessed 6 June 2016

  19. Mannami T, Konishi M, Baba S, Nishi N, Terao A (1997) Prevalence of asymptomatic carotid atherosclerotic lesions detected by high-resolution ultrasonography and its relation to cardiovascular risk factors in the general population of a Japanese city: the Suita study. Stroke 28:518–525

    Article  CAS  PubMed  Google Scholar 

  20. Arima H, Tanizaki Y, Kiyohara Y et al (2003) Validity of the JNC VI recommendations for the management of hypertension in a general population of Japanese elderly: the Hisayama study. Arch Intern Med 163:361–366

    Article  PubMed  Google Scholar 

  21. Ohkubo T, Kikuya M, Metoki H et al (2005) Prognosis of “masked” hypertension and “white-coat” hypertension detected by 24-h ambulatory blood pressure monitoring 10-year follow-up from the Ohasama study. J Am Coll Cardiol 46:508–515

    Article  PubMed  Google Scholar 

  22. Kuriyama S, Shimazu T, Ohmori K et al (2006) Green tea consumption and mortality due to cardiovascular disease, cancer, and all causes in Japan: the Ohsaki study. JAMA 296:1255–1265

    Article  CAS  PubMed  Google Scholar 

  23. World Health Organization (1977) Manual of the international statistical classification of diseases, injuries, and causes of death. 9th rev. WHO, Geneva

    Google Scholar 

  24. World Health Organization (1992) International statistical classification of diseases and related health problems, 10th edn. WHO, Geneva

    Google Scholar 

  25. American Diabetes Association (2015) Classification and diagnosis of diabetes. Diabetes Care 38:S8–S16

    Article  Google Scholar 

  26. Tada N, Maruyama C, Koba S et al (2011) Japanese dietary lifestyle and cardiovascular disease. J Atheroscler Thromb 18:723–734

    Article  PubMed  Google Scholar 

  27. Brown IJ, Tzoulaki I, Candeias V, Elliott P (2009) Salt intakes around the world: implications for public health. Int J Epidemiol 38:791–813

    Article  PubMed  Google Scholar 

  28. Zhou BF, Stamler J, Dennis B et al (2003) Nutrient intakes of middle-aged men and women in China, Japan, United Kingdom, and United States in the late 1990s: the INTERMAP study. J Hum Hypertens 17:623–630

    Article  CAS  PubMed  Google Scholar 

  29. Regel I, Kong B, Raulefs S et al (2012) Energy metabolism and proliferation in pancreatic carcinogenesis. Langenbecks Arch Surg 397:507–512

    Article  PubMed  Google Scholar 

  30. Chaika NV, Yu F, Purohit V et al (2012) Differential expression of metabolic genes in tumor and stromal components of primary and metastatic loci in pancreatic adenocarcinoma. PLoS ONE 7:e32996

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Grote VA, Rohrmann S, Nieters A et al (2011) Diabetes mellitus, glycated haemoglobin and C-peptide levels in relation to pancreatic cancer risk: a study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Diabetologia 54:3037–3046

    Article  CAS  PubMed  Google Scholar 

  32. Chang YC, Chuang LM (2010) The role of oxidative stress in the pathogenesis of type 2 diabetes: from molecular mechanism to clinical implication. Am J Transl Res 2:316–331

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Biadgo B, Abebe M (2016) Type 2 diabetes mellitus and its association with the risk of pancreatic carcinogenesis: a review. Korean J Gastroenterol 67:168–177

    Article  PubMed  Google Scholar 

  34. Akatsuka S, Toyokuni S (2012) Genome-wide assessment of oxidatively generated DNA damage. Free Radic Res 46:523–530

    Article  CAS  PubMed  Google Scholar 

  35. Stolzenberg-Solomon RZ, Graubard BI, Chari S et al (2005) Insulin, glucose, insulin resistance, and pancreatic cancer in male smokers. JAMA 294:2872–2878

    Article  CAS  PubMed  Google Scholar 

  36. Hirata T, Higashiyama A, Kubota Y et al (2015) HOMA-IR values are associated with glycemic control in Japanese subjects without diabetes or obesity: the KOBE study. J Epidemiol 25:407–414

    Article  PubMed  Google Scholar 

  37. Hanefeld M, Koehler C, Fuecker K, Henkel E, Schaper F, Temelkova-Kurktschiev T (2003) Insulin secretion and insulin sensitivity pattern is different in isolated impaired glucose tolerance and impaired fasting glucose: the risk factor in Impaired glucose tolerance for atherosclerosis and diabetes study. Diabetes Care 26:868–874

    Article  CAS  PubMed  Google Scholar 

  38. Abdul-Ghani MA, Williams K, DeFronzo R, Stern M (2006) Risk of progression to type 2 diabetes based on relationship between postload plasma glucose and fasting plasma glucose. Diabetes Care 29:1613–1618

    Article  CAS  PubMed  Google Scholar 

  39. Hu FB (2008) Obesity Epidemiology. Oxford University Press, New York

    Book  Google Scholar 

  40. Lin Y, Fu R, Grant E et al (2013) Association of body mass index and risk of death from pancreatic cancer in Asians: findings from the Asia Cohort Consortium. Eur J Cancer Prev 22:244–250

    Article  PubMed  Google Scholar 

  41. Lawes CM, Parag V, Bennett DA et al (2004) Blood glucose and risk of cardiovascular disease in the Asia Pacific region. Diabetes Care 27:2836–2842

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We are grateful to all the participants in each cohort study. We thank Mrs. Toshimi Yoshida (Shiga University of Medical Science) and Mrs. Satoko Narikawa (Keio University) for expert clerical assistance.

Author contributions

HU, TO, and KM conceived and designed the pooling project. YM constructed the EPOCH-JAPAN database. MN and AT contributed to the design of the study. MN, YM, and ST participated in data analysis. MN and AT participated in the writing of the manuscript. All authors participated in the critical revision of the manuscript and approved the final version of the report for submission.

Funding

This research was supported by a grant–in–aid from the Ministry of Health, Labour and Welfare, Health and Labor Sciences research grants, Japan (Research on Health Services: H17–Kenkou–007; Comprehensive Research on Cardiovascular Disease and Life–Related Disease: H18–Junkankitou[Seishuu]–Ippan–012; Comprehensive Research on Cardiovascular Disease and Life–Related Disease: H19–Junkankitou [Seishuu]–Ippan–012; Comprehensive Research on Cardiovascular and Life–Style Related Diseases: H20–Junkankitou [Seishuu]–Ippan–013; Comprehensive Research on Cardiovascular and Life–Style Related Diseases: H23–Junkankitou [Seishuu]–Ippan–005); an Intramural Research Fund (22-4-5) for Cardiovascular Diseases of National Cerebral and Cardiovascular Center; and Comprehensive Research on Cardiovascular and Life-Style Related Diseases (H26-Junkankitou [Seisaku]-Ippan-001).

Author information

Authors and Affiliations

  1. Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8573, Japan

    Masato Nagai

  2. Graduate School of Medicine, Tohoku University, Sendai, Japan

    Masato Nagai

  3. Department of Medical Statistics, Toho University School of Medicine, Tokyo, Japan

    Yoshitaka Murakami

  4. Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Akiko Tamakoshi & Shigekazu Ukawa

  5. Departments of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yutaka Kiyohara

  6. Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan

    Michiko Yamada

  7. Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan

    Takumi Hirata

  8. Department of Medical Statistics, Shiga University of Medical Science, Otsu, Japan

    Sachiko Tanaka

  9. Department of Public Health, Shiga University of Medical Science, Otsu, Japan

    Katsuyuki Miura & Hirotsugu Ueshima

  10. Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan

    Katsuyuki Miura & Hirotsugu Ueshima

  11. Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan

    Tomonori Okamura

Authors
  1. Masato Nagai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshitaka Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akiko Tamakoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yutaka Kiyohara
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michiko Yamada
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shigekazu Ukawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takumi Hirata
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sachiko Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Katsuyuki Miura
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hirotsugu Ueshima
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Tomonori Okamura
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN) Research Group

Corresponding author

Correspondence to Masato Nagai.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest associated with this manuscript.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 35 KB)

Appendix

Appendix

The Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH–JAPAN) Research Group is composed of the following investigators. Chairperson: Hirotsugu Ueshima (Shiga University of Medical Science); Co–Chairperson: Tomonori Okamura (Keio University);

Executive committee: Hirotsugu Ueshima (Shiga University of Medical Science), Yutaka Imai (Tohoku University Graduate School of Pharmaceutical Sciences), Takayoshi Ohkubo (Teikyo University School of Medicine), Fujiko Irie (Ibaraki Prefecture), Hiroyasu Iso, Akihiko Kitamura (Osaka University Graduate School of Medicine), Yutaka Kiyohara (Kyushu University Graduate School of Medicine), Katsuyuki Miura (Shiga University of Medical Science), Yoshitaka Murakami (Toho University), Hideaki Nakagawa (Kanazawa Medical University), Takeo Nakayama (Kyoto University School of Public Health), Akira Okayama (Research Institute of Strategy for Prevention), Toshimi Sairenchi (Dokkyo Medical University), Shigeyuki Saitoh (Sapporo Medical University), Kiyomi Sakata (Iwate Medical University), Akiko Tamakoshi (Hokkaido University Graduate School of Medicine), Ichiro Tsuji (Tohoku University Graduate School of Medicine), Michiko Yamada (Radiation Effects Research Foundation), Masahiko Kiyama (Osaka Center for Cancer and Cardiovascular Disease Prevention), Yoshihiro Miyamoto (National Cerebral and Cardiovascular Center), Shizukiyo Ishikawa (Jichi Medical University), Hiroshi Yatsuya (Fujita Health University), and Tomonori Okamura (Keio University School of Medicine).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nagai, M., Murakami, Y., Tamakoshi, A. et al. Fasting but not casual blood glucose is associated with pancreatic cancer mortality in Japanese: EPOCH-JAPAN. Cancer Causes Control 28, 625–633 (2017). https://doi.org/10.1007/s10552-017-0884-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-017-0884-0

Keywords

Search

Navigation