Elevated glycated haemoglobin (HbA1c) is associated with an increased risk of pancreatic ductal adenocarcinoma: A UK Biobank cohort study

Declan McDonnell, Adrian W E Cheang, Sam Wilding, Sarah H Wild, Adam E Frampton, Christopher D Byrne, Zaed Z Hamady

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

BACKGROUND: The role of dysglycaemia as a risk marker for Pancreatic Ductal Adenocarcinoma (PDAC) is uncertain. We investigated the relationship between glycated haemoglobin (HbA1c) and incident PDAC using a retrospective cohort study within the UK Biobank.

METHODS: A study involving 499,804 participants from the UK Biobank study was undertaken. Participants were stratified by diabetes mellitus (DM) status, and then by HbA1c values < 42 mmol/mol, 42-47 mmol/mol, or ≥48 mmol/mol. Cox proportional hazard models were used to describe the association between HbA1c category (with time-varying interactions) and incident PDAC.

RESULTS: PDAC occurred in 1157 participants during 11.6 (10.9-12.3) years follow up [(median (interquartile range)]. In subjects without known DM at baseline, 12 months after recruitment, the adjusted hazard ratios (aHR, 95% CI) for incident PDAC for HbA1c 42-47 mmol/mol compared to HbA1c < 42 mmol/mol (reference group) was 2.10 (1.31-3.37, p = 0.002); and was 8.55 (4.58-15.99, p < 0.001) for HbA1c ≥ 48 mmol/mol. The association between baseline HbA1c and incident PDAC attenuated with increasing duration of time of follow-up to PDAC diagnosis.

CONCLUSIONS: Dysglycaemia detected by elevated HbA1c is associated with an increased risk of PDAC. The strength of the association between elevated HbA1c and incident PDAC is inversely proportional to the time from detecting dysglycaemia but remains significant for at least 60 months following HbA1c testing.

Original languageEnglish
Article number4078
Number of pages13
JournalCancers
Volume15
Issue number16
DOIs
Publication statusPublished - 13 Aug 2023

Keywords / Materials (for Non-textual outputs)

  • pancreatic
  • adenocarcinoma
  • PDAC
  • diabetes
  • NODM
  • HbA1c
  • T3cDM

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