| [ Summary ] |
In Japan, the number of patients with diabetes has been increasing rapidly in recent years due to a westernization of lifestyles. Several studies have shown associations between diabetes and various types of cancer, other than gastric cancer. We examined the impact of fasting plasma glucose (FPG) levels on gastric cancer occurrence in a cohort survey of 2,466 subjects aged 40 years or older selected from residents of Hisayama Town. Multivariate analysis with Cox's proportional hazards model revealed that the risks of gastric cancer in modest and high FPG groups were significantly higher than those in the low FPG group, even after adjusting for other comprehensive risk factors, including Helicobacter pylori status, smoking, and dietary factors. However, this FPG-cancer association was observed only in Helicobacter pylori-seropositive subjects. Our findings suggest that a modest increase in FPG is a risk factor for gastric cancer, and that hyperglycemia is a possible cofactor increasing the risk posed by Helicobacter pylori infection.
Some previous reports suggest possible mechanisms of carcinogenesis through hyperglycermia, for example, oxidative stress induced DNA damage, however, a precise pathogenesis explaining the association between hyperglycemia and the risk of gastric cancer is not known. Further study is necessary to clarify the pathogenetic role of hyperglycemia in gastric carcinogenesis. |