Long‐term Risk of Malignant Neoplastic Disorders in Type 2 Diabetes Mellitus Patients with Metabolic Syndrome

Oana Albai,1,2 Mirela Frandes,3 Bogdan Timar,2,3 Diana-Loreta Paun,4 Deiana Roman,1 Romulus Timar1,2 1Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 2Department of Diabetes and Metabolic Diseases, “Pius Brinzeu” Emergency Hospital, Timisoara, Romania; 3Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 4Department of Public Health, Department of Endocrinology, “Carol Davila” University of Medicine and Pharmacy, Bucuresti, RomaniaCorrespondence: Mirela FrandesDepartment of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu, Timisoara 300041, RomaniaTel +40 731117020Fax +40 256462856Email mirela.frandes@umft.roBackground: In developing countries, cancer incidence has progressively increased, becoming the second cause of mortality after cardiovascular diseases. Type 2 diabetes mellitus (T2DM) is associated with an increased risk of malignant neoplastic disorders, especially pancreatic cancer, colorectal cancer, and breast cancer.Aim: The main aim of our study was to establish the prevalence of malignant neoplastic disorders in patients previously diagnosed with T2DM. Also, we have investigated the association between the components of the metabolic syndrome (MetS) and the different types of diagnosed malignant neoplasms.Methods: We performed a retrospective, population-based cohort study of 1,027 patients with T2DM from the Center for Diabetes Treatment of the “Pius Brînzeu” Emergency Hospital in Timisoara, Romania. The patients were followed up every three or six months, depending on their antidiabetic treatment. The patients who developed malignant neoplasms were registered and referred to oncology centers. The potential risk factors for malignancies in patients with T2DM were evaluated using logistic regression adjusting for possible confounders.Results: The prevalence of malignant neoplastic disorders in our study group was 7.1%; more precisely, we found 2.2% colon neoplasm, 2.9% mammary neoplasm, 0.7% lymphomas, 0.6% pulmonary neoplasm, 0.3% pancreatic neoplasm, and 0.4% prostate neoplasm. The presence of malignant neoplastic disorders was associated in our cohort of patients with T2DM with higher cholesterol (237.71± 47.82 vs 202.52± 52.16 mg/dL; p=0.005) and triglycerides levels (215.91± 52.41 vs 180.75± 54.32 mg/dL; p< 0.001), as well as higher body mass index (33.37± 3.87 vs 28.42± 3.56 kg/m2; p< 0.001) and abdominal circumference (110.11± 14.48 vs 98.12± 15.73 cm; p< 0.001). Also, we found that insulin-based treatment was an independent risk factor, the patients presenting ten times higher odds of developing malignant neoplastic disorders.Conclusion: The prevalence of malignant neoplastic disorders in our study group was 7.1%. Also, the prevalence of malignant neoplastic disorders was higher in patients with T2DM and MetS as compared to the general population of T2DM patients.Keywords: malignant neoplastic disorders, type 2 diabetes mellitus, hyperinsulinemia, metabolic syndrome, insulin resistance