title: A Linear Dose-Response Relationship between Fasting Plasma Glucose and Colorectal Cancer Risk: Systematic Review and Meta-analysis.
abstract: For many years, the question of whether hyperglycaemia, a manifestation of prediabetes, diabetes mellitus and metabolic syndrome, is a risk factor for colorectal cancer has been intensely studied. In fact, even after the conclusion of several prospective studies, the topic is still controversial. We conducted a systematic review and meta-analysis to investigate the dose-response relationship between blood glucose concentration and the incidence of colorectal cancer. A linear (P = 0.303 for non-linearity) dose-response relationship was observed between fasting plasma glucose (FPG) and colorectal cancer risk without significant heterogeneity. The relative risk (RR) for colorectal cancer per 20 mg/dL increase in FPG was 1.015 (95% CI: 1.012-1.019, P = 0.000). In subgroup analyses, the pooled RRs for colon cancer (CC) and rectal cancer (RC) studies were 1.035 (95% CI 1.008-1.062, P = 0.011) and 1.031 (95% CI: 0.189-5.628, P = 0.972), respectively; in the analysis comparing men and women, the pooled RRs were 1.016 (95% CI: 1.012-1.020, P = 0.000) and 1.011 (95% CI: 0.995-1.027, P = 0.164), respectively. Sensitivity analyses using two methods showed similar results. In conclusion, there is a significant linear dose-response relationship between FPG and the incidence risk of colorectal cancer. For people with diabetes or prediabetes, controlling blood glucose might be useful to prevent colorectal cancer.
authors.affiliation: Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Shi
authors.affiliation: Department of Infectious Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Xiong
authors.affiliation: State Key Laboratory of Environment Health (Incubation, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.|Ministry of Education) Key Laboratory of Environment &Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.|Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.|Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
authors.forename: Jiaoyuan
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Cao
authors.affiliation: Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Jiang
authors.affiliation: Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Environment Health (Incubation, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.|Ministry of Education) Key Laboratory of Environment &Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.|Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.|Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
authors.forename: Xueqin
authors.initials: X
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Environment Health (Incubation, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.|Ministry of Education) Key Laboratory of Environment &Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.|Ministry of Environmental Protection Key Laboratory of Environment and Health (Wuhan), Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.|Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
authors.forename: Guobin
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
authors.forename: Kailin
authors.initials: K
authors.lastname: Cai
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003110:Colonic Neoplasms / Q000097:blood*; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D012004:Rectal Neoplasms / Q000097:blood*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose