title: Increased incidence of non-Hodgkin lymphoma, leukemia, and myeloma in patients with diabetes mellitus type 2: a meta-analysis of observational studies.
abstract: Hematologic malignancies are a heterogeneous group of conditions with an unclear etiology. We hypothesized that diabetes mellitus type 2 is associated with increased risk of developing lymphoma, leukemia, and myeloma. A literature search identified 26 studies (13 case-control and 13 cohort studies) evaluating such an association. Outcome was calculated as the odds ratio (OR) using a random effects model. Heterogeneity and publication bias were evaluated using the I(2) index and the trim-and-fill analysis, respectively. Quality was assessed using the Newcastle-Ottawa scale. The OR for non-Hodgkin lymphoma was increased at 1.22 (95% confidence interval [CI], 1.07-1.39; P < .01) but the OR for Hodgkin lymphoma was not. There was an increased OR for peripheral T-cell lymphoma (OR = 2.42, 95% CI, 1.24-4.72; P = .009) but not for other non-Hodgkin lymphoma subtypes. The OR for leukemia was 1.22 (95% CI, 1.03-1.44; P = .02) and the OR for myeloma was 1.22 (95% CI, 0.98-1.53; P = .08). Although diabetes mellitus type 2 seems to increase the risk of developing lymphoma, leukemia, and myeloma, future studies should focus on evaluating other potential confounders such as obesity, dietary habits, physical activity, and/or antidiabetic therapy.
authors.affiliation: Division of Hematology and Oncology, Rhode Island Hospital/The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02906, USA. jcastillo@lifespan.org
authors.forename: Jorge J
authors.initials: JJ
authors.lastname: Castillo
authors.forename: Nikhil
authors.initials: N
authors.lastname: Mull
authors.forename: John L
authors.initials: JL
authors.lastname: Reagan
authors.forename: Saed
authors.initials: S
authors.lastname: Nemr
authors.forename: Joanna
authors.initials: J
authors.lastname: Mitri
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000150:complications / Q000453:epidemiology*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000453:epidemiology*; D008297:Male; D009101:Multiple Myeloma / Q000150:complications / Q000453:epidemiology*