Serum vascular adhesion protein-1 level predicts risk of incident cancers in subjects with type II diabetes.
BACKGROUND
Serum vascular adhesion protein-1 (VAP-1) predicts cancer-related mortality in diabetic subjects. However, whether serum VAP-1 predicts cancer incidence or cancer progression remains unclear. We conducted a cohort study to investigate whether serum VAP-1 and related clinical variables predict incident cancers in type II diabetic subjects.


METHODS
From 1996 to 2003, we enrolled 568 type II diabetic subjects who were free of cancer at baseline. Serum VAP-1 at enrollment was measured by time-resolved immunofluorometric assay. Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate <60 mL/min per 1.73 m(2). The subjects were followed until first occurrence of cancer or until December 31, 2011.


RESULTS
During a mean follow-up of 11.3 years, 71 subjects developed incident cancers. The HRs for incident cancers in subjects with highest tertile of serum VAP-1 and in subjects with CKD were 2.95 [95% confidence interval (CI), 1.31-6.63; P = 0.009] and 2.29 (95% CI, 1.18-4.44; P = 0.015), respectively, after multivariate adjustment. There was an interaction between serum VAP-1 and CKD on the risk of incident cancers (P = 0.01 for log-transformed VAP-1 × CKD). The relationship among serum VAP-1, CKD, and incident cancers was similar if death was considered in the competing risk models or if subjects with shorter follow-up period were excluded.


CONCLUSIONS
Higher serum VAP-1 and CKD can independently predict future development of cancers in type II diabetic subjects.


CONCLUSIONS
Physicians should be aware of the early signs of cancer in diabetic individuals with elevated VAP-1 or renal dysfunction. More aggressive treatment strategies might be considered.
Authors' Affiliations: Department of Internal Medicine, En Chu Kong Hospital, New Taipei City;
Tse-Ya
TY
Yu
Department of Internal Medicine, National Taiwan University Hospital, Taipei; and.
Hung-Yuan
HY
Li
Department of Internal Medicine, National Taiwan University Hospital, Taipei; and.
Yi-Der
YD
Jiang
Department of Internal Medicine, National Taiwan University Hospital, Taipei; and.
Tien-Jyun
TJ
Chang
Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
Jung-Nan
JN
Wei
Authors' Affiliations: Department of Internal Medicine, En Chu Kong Hospital, New Taipei City;
Chi-Ming
CM
Lin
Authors' Affiliations: Department of Internal Medicine, En Chu Kong Hospital, New Taipei City;
Ching-Chi
CC
Chu
Graduate Institute of Clinical Medicine, Medical College and Graduate Institute of Preventive Medicine, National Taiwan University School of Public Health, National Taiwan University; Department of Internal Medicine, National Taiwan University Hospital, Taipei; and leeming@ntu.edu.tw.
Lee-Ming
LM
Chuang
D006631:Amine Oxidase (Copper-Containing) / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D015815:Cell Adhesion Molecules / Q000097:blood*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology*; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology
D014408:Biomarkers, Tumor; D015815:Cell Adhesion Molecules; C076668:AOC3 protein, human; D006631:Amine Oxidase (Copper-Containing)