DIABETES AND CANCER-AN AACE/ACE CONSENSUS STATEMENT

被引：67

作者：

Handelsman, Yehuda ^{[1
]}

LeRoith, Derek ^{[2
]}

Bloomgarden, Zachary T. ^{[3
]}

Dagogo-Jack, Samuel ^{[4
]}

Einhorn, Daniel ^{[5
]}

Garber, Alan J. ^{[6
,7
]}

Grunberger, George ^{[8
]}

Harrell, R. Mack ^{[9
]}

Gagel, Robert F. ^{[10
]}

Lebovitz, Harold E. ^{[11
]}

McGill, Janet B. ^{[12
]}

Hennekens, Charles H. ^{[13
]}

机构：

[1] Metab Inst Amer, Tarzana, CA USA

[2] Dept Med, Div Endocrinol Diabet & Bone Dis, New York, NY USA

[3] Mt Sinai Sch Med, Dept Med, New York, NY USA

[4] Univ Tennessee, Ctr Hlth Sci, Div Endocrinol Diabet & Metab, Memphis, TN 38163 USA

[5] Scripps Whittier Diabet Inst, La Jolla, CA USA

[6] Baylor Coll Med, Dept Biochem & Mol Biol, Houston, TX 77030 USA

[7] Baylor Coll Med, Dept Mol & Cellular Biol, Houston, TX 77030 USA

[8] Grunberger Diabet Inst, Bloomfield Hills, MI USA

[9] Mem Ctr Integrat Endocrine Surg, Hollywood, FL USA

[10] Univ Texas MD Anderson Canc Ctr, Div Internal Med, Houston, TX 77030 USA

[11] SUNY Hlth Sci Ctr, Div Endocrinol & Metab Diabet, Brooklyn, NY USA

[12] Washington Univ, Sch Med, St Louis, MO USA

[13] Florida Atlantic Univ, Charles E Schmidt Coll Med, Boca Raton, FL 33431 USA

来源：

ENDOCRINE PRACTICE | 2013年 / 19卷 / 04期

关键词：

BODY-MASS INDEX; STAGE BREAST-CANCER; GROWTH-FACTOR; COLORECTAL-CANCER; BLADDER-CANCER; ENDOMETRIAL CANCER; ACUTE-PANCREATITIS; PROSTATE-CANCER; ENERGY-BALANCE; CHEMICAL CARCINOGENESIS;

D O I：

10.4158/EP13248.CS

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Epidemiologic data have demonstrated significant increases of various cancers in people with obesity and diabetes. Recently, concern has emerged that antihyperglycemic medications may also be associated with an increased prevalence of multiple cancers; however, available data are limited and conflicting. The American Association of Clinical Endocrinologists (AACE) convened a conference to review factors associated with cancer development in people with obesity and diabetes and to discuss the possible cancer risk of antihyperglycemic medications. Increased body mass index is associated with an increased risk of multiple cancers based on observational epidemiological data, and is closely associated with increased levels of endogenous insulin, insulin-like growth factors, inflammatory cytokines, and other factors that can have downstream pro-cancer growth effects. The role of hyperglycemia in cancer development is less clear, but an association cannot be ruled out, as current observational data additionally suggest an increased cancer risk in people with diabees. There is currently insufficient evidence that antihyperglycemic medications may be definitively associated with an increased cancer risk owing to a lack of data from large-scale randomized study designs. Similarly, there is also insufficient evidence showing a positive impact of these medications on cancer development. Clinicians can continue to confidently prescribe all FDA-approved antihyperglycemic medications for the management of hyperglycemia according to established practice guidelines. In patients who have an elevated cancer risk or positive family history of cancer, the cautious selection of antihyperglycemic medications is both prudent and warranted. The AACE additionally advocates for the improved treatment and management of obesity, early cancer screening in patients at increased risk, increased research collaboration, and improved study designs to address outstanding concerns surrounding the diabetes-cancer relationship.© 2013 AACE.

引用

页码：675 / 693

页数：19

共 129 条

[1] Multi-stage chemical carcinogenesis in mouse skin: Fundamentals and applications [J].