title: Fasting but not casual blood glucose is associated with pancreatic cancer mortality in Japanese: EPOCH-JAPAN.
abstract: OBJECTIVE
  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.
authors.affiliation: Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8573, Japan. m-nagai@med.tohoku.ac.jp.|Graduate School of Medicine, Tohoku University, Sendai, Japan. m-nagai@med.tohoku.ac.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Nagai
authors.affiliation: Department of Medical Statistics, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Murakami
authors.affiliation: Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamakoshi
authors.affiliation: Departments of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
authors.affiliation: Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Yamada
authors.affiliation: Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Ukawa
authors.affiliation: Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Hirata
authors.affiliation: Department of Medical Statistics, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.|Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.|Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
authors.affiliation: Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003920:Diabetes Mellitus / Q000097:blood; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood / Q000401:mortality*; D011237:Predictive Value of Tests; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: Blood glucose; EPOCH-JAPAN; Japanese; Meta-analysis; Pancreatic cancer