A retrospective cohort study on the impact of hemoglobin A1c variability on the incidence of malignant tumors in patients with type 2 diabetes mellitus in Minhang District, Shanghai
10.3969/j.issn.1006-2483.2025.05.015
- VernacularTitle:糖化血红蛋白波动对上海市闵行区2型糖尿病患者恶性肿瘤发病影响的回顾性队列研究
- Author:
Pu LIU
1
;
Qiongjin MA
2
;
Jun LI
2
Author Information
1. Community Health Service Center Of Zhuanqiao District，Shanghai 201108 , China
2. Minhang District Center for Disease Control and Prevention , Shanghai 201101 , China
- Publication Type:Journal Article
- Keywords:
Type 2 diabetes mellitus;
Neoplasms;
Hemoglobin A1c variability
- From:
Journal of Public Health and Preventive Medicine
2025;36(5):67-70
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of hemoglobin A1c variability on the incidence of malignant tumors in type 2 diabetes mellitus (T2DM) patients, and to provide a reference for the prevention and treatment of diabetes. Methods A retrospective cohort study was used to integrate Shanghai malignant tumor registration information and T2DM patient management information of Minhang Districts in Shanghai. A record linkage was carried out using ID numbers for patients who had been diagnosed through the Cancer Registry System. Average Real Variability（ARV）was used to assess the variability for hemoglobin A1c results, with no less than 3 measurements and no more than 1 follow-up visit per year. Cox proportional hazards regression models and Restricted Cubic Splines (RCS) were used for statistical analysis. ARV was grouped using quartile classification, represented by Q1, Q2, Q3, and Q4, respectively. Cox regression was performed using unadjusted model I and model II adjusted for gender, age, and group. Results A total of 2 762 research subjects were included in the present study, with 45.84% males and 54.16% females. The average age was (63.58±10.11) years, and an average follow-up time was (9.96±3.66) years. Malignant tumor incidence rate was 345.45/100 000 person years. There was statistical significance among different ARV groups (P=0.01). COX regression analysis of model I and model II showed that compared with Q1, the risk of Q4 group was significantly increased, with HRs of 2.72 (1.56-4.74) and 2.68 (1.53-4.68), respectively. The RCS graph's analysis showed that except for the ≥65-year-old group, the risk of tumor incidence gradually increased with the increase of ARV coefficient. Conclusion The variability of hemoglobin A1c is positively associated with the risk of occurrence of malignant tumors in type 2 diabetes patients. It is necessary to strengthen the monitoring of hemoglobin A1c and to reduce the health hazards caused by fluctuations in hemoglobin A1c.
