Diabetes, atherosclerosis increase cancer risks
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Adults with diabetes and those with more than 50% carotid stenosis are at greater risks for cancer than those without diabetes and those with less than 50% carotid stenosis, according to findings published in Nutrition, Metabolism & Cardiovascular Diseases.
“We found a significant association between elevated carotid atherosclerotic burden and subsequent cancer diagnosis. Interestingly, among classic risk factors, only diabetes remained significantly associated with study outcome,” Stefano Rizza, MD, PhD, of the department of systems medicine at the University of Rome Tor Vergata in Italy, and colleagues wrote. “Our data suggest a specific interaction between diabetes and atherosclerosis to increase cancer risk.”
Rizza and colleagues assessed cancer incidence across 4 years of follow-up among 766 adults. The researchers measured carotid stenosis via carotid ultrasound between 2014 and 2018 in Rome at the Center for the Atherosclerosis of the Policlinico Tor Vergata. The researchers observed 90 participants with more than 50% carotid stenosis (mean age, 76 years; 47.7% women) and 676 with less than 50% (mean age, 59.9 years; 46.6% women). The researchers used medical records and follow-up phone calls with participants to identify cases of cancer in the study population.
Those with more than 50% carotid stenosis were considered to have “significant carotid atherosclerosis burden,” and 11.1% of them developed cancer (n = 10) vs. 2.1% of those with less than 50% carotid stenosis (n = 14; P < .001). In addition, 75% of those who developed cancer had diabetes compared with 37.3% of those who did not develop cancer (P < .001).
The risk for cancer was 2.831 times greater for those with more than 50% carotid stenosis vs. less than 50% carotid stenosis (HR = 2.831; 95% CI, 1.034-5.714) and 4.831 times greater for those with diabetes vs. without diabetes (HR = 4.831; 95% CI, 1.506-15.501).
“Individuals with high levels of circulating oxidized LDL and LOX-1 expression, such as diabetic patients, seem to be more prone to develop cancer, implying a mechanistic overlap in the pathobiology of atherogenesis, diabetes and tumorigenesis,” the researchers wrote. “Even if this report needs replication in prospective larger studies, to our knowledge this is the first study reporting a significant risk of cancer development in subjects with diabetes and high risk of cerebrovascular events, highlighting the need of a carefully clinical screening for cancer in patients with overt clinical atherosclerosis.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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