{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T05:38:39Z","timestamp":1775453919390,"version":"3.50.1"},"reference-count":47,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017649","name":"Hong Kong Government","doi-asserted-by":"publisher","award":["S2019.A4.015.19S"],"award-info":[{"award-number":["S2019.A4.015.19S"]}],"id":[{"id":"10.13039\/501100017649","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,3,13]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare metabolic dysfunction-associated profiles between patients with diabetes who developed different obesity-related site-specific cancers and those who remained free of cancer during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Public general outpatient clinics in Hong Kong.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients with diabetes without a history of malignancy (n=391\u2009921).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>The outcomes of interest were diagnosis of site-specific cancers (colon and rectum, liver, pancreas, bladder, kidney and stomach) during follow-up. Cox proportional hazards regression was applied to assess the associations between metabolic dysfunction and other clinical factors with each site-specific cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Each 0.1 increase in waist-to-hip ratio was associated with an 11%\u201335% elevated risk of colorectal, bladder and liver cancers. Each 1% increase in glycated haemoglobin was linked to a 4%\u20139% higher risk of liver and pancreatic cancers. While low-density lipoprotein cholesterol and triglycerides were inversely associated with the risk of liver and pancreatic cancers, high-density lipoprotein cholesterol was negatively associated with pancreatic, gastric and kidney cancers, but positively associated with liver cancer. Furthermore, liver cirrhosis was linked to a 56% increased risk of pancreatic cancer. No significant association between hypertension and cancer risk was found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Metabolic dysfunction-associated profiles contribute to different obesity-related cancer outcomes differentially among patients with diabetes. This study may provide evidence to help identify cancer prevention targets during routine diabetes care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-082414","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T13:53:46Z","timestamp":1712152426000},"page":"e082414","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Metabolic dysfunction-associated profiles and subsequent site-specific risk of obesity-related cancers among Chinese patients with diabetes: a retrospective cohort study"],"prefix":"10.1136","volume":"14","author":[{"given":"Sarah Tsz Yui","family":"Yau","sequence":"first","affiliation":[{"name":"JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8267-1785","authenticated-orcid":false,"given":"Eman","family":"Leung","sequence":"additional","affiliation":[{"name":"JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7706-9370","authenticated-orcid":false,"given":"Martin Chi Sang","family":"Wong","sequence":"additional","affiliation":[{"name":"JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi Tim","family":"Hung","sequence":"additional","affiliation":[{"name":"JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5610-1298","authenticated-orcid":false,"given":"Ka Chun","family":"Chong","sequence":"additional","affiliation":[{"name":"JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5888-5660","authenticated-orcid":false,"given":"Albert","family":"Lee","sequence":"additional","affiliation":[{"name":"JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eng Kiong","family":"Yeoh","sequence":"additional","affiliation":[{"name":"JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,4,3]]},"reference":[{"key":"2025120520361774000_14.4.e082414.1","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-S002"},{"key":"2025120520361774000_14.4.e082414.2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.1291"},{"key":"2025120520361774000_14.4.e082414.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2011.03.003"},{"key":"2025120520361774000_14.4.e082414.4","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji375"},{"key":"2025120520361774000_14.4.e082414.5","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000008588","article-title":"Diabetes mellitus and the risk of bladder cancer: a PRISMA-compliant meta-analysis of cohort studies","volume":"96","author":"Xu","year":"2017","journal-title":"Medicine (Baltimore)"},{"key":"2025120520361774000_14.4.e082414.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-011-2051-6"},{"key":"2025120520361774000_14.4.e082414.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr1606602"},{"key":"2025120520361774000_14.4.e082414.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2010.04.012"},{"key":"2025120520361774000_14.4.e082414.9","doi-asserted-by":"publisher","DOI":"10.1242\/dmm.001180"},{"key":"2025120520361774000_14.4.e082414.10","doi-asserted-by":"crossref","first-page":"6263","DOI":"10.2147\/CMAR.S181178","article-title":"The association between metabolic syndrome and bladder cancer susceptibility and prognosis: an updated comprehensive evidence synthesis of 95 observational studies involving 97,795,299 subjects","volume":"10","author":"Peng","year":"2018","journal-title":"Cancer Manag Res"},{"key":"2025120520361774000_14.4.e082414.11","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyu082"},{"key":"2025120520361774000_14.4.e082414.12","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/CEJ.0000000000000703","article-title":"The association between diabetes and gastric cancer: results from the stomach cancer pooling project consortium","volume":"31","author":"Dabo","year":"2022","journal-title":"Eur J Cancer Prev"},{"key":"2025120520361774000_14.4.e082414.13","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1097\/CEJ.0000000000000618","article-title":"Metabolic syndrome and gastric cancer risk: a systematic review and meta-analysis","volume":"30","author":"Mariani","year":"2021","journal-title":"Eur J Cancer Prev"},{"key":"2025120520361774000_14.4.e082414.14","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.16816"},{"key":"2025120520361774000_14.4.e082414.15","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g7371","article-title":"Blood glucose concentration and risk of Pancreatic cancer: systematic review and dose-response meta-analysis","volume":"350","author":"Liao","year":"2015","journal-title":"BMJ"},{"key":"2025120520361774000_14.4.e082414.16","doi-asserted-by":"crossref","DOI":"10.1136\/bmjdrc-2020-001600","article-title":"Risk of 16 cancers across the full Glycemic spectrum: a population-based cohort study using the UK Biobank","volume":"8","author":"Rentsch","year":"2020","journal-title":"BMJ Open Diabetes Res Care"},{"key":"2025120520361774000_14.4.e082414.17","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-019-45014-4","article-title":"Association between blood pressure and risk of cancer development: a systematic review and meta-analysis of observational studies","volume":"9","author":"Seretis","year":"2019","journal-title":"Sci Rep"},{"key":"2025120520361774000_14.4.e082414.18","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.cgh.2010.10.014","article-title":"Increased risk for malignant Neoplasms among patients with cirrhosis","volume":"9","author":"Kalaitzakis","year":"2011","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025120520361774000_14.4.e082414.19","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1038\/s41416-023-02204-2","article-title":"Is it still worth pursuing the Repurposing of metformin as a cancer therapeutic","volume":"128","author":"Lord","year":"2023","journal-title":"Br J Cancer"},{"key":"2025120520361774000_14.4.e082414.20","doi-asserted-by":"crossref","DOI":"10.1007\/s11912-021-01023-z","article-title":"Statins as potential Chemoprevention or therapeutic agents in cancer: a model for evaluating Repurposed drugs","volume":"23","author":"Joharatnam-Hogan","year":"2021","journal-title":"Curr Oncol Rep"},{"key":"2025120520361774000_14.4.e082414.21","article-title":"Role of nonsteroidal anti-inflammatory drugs (NSAIDs) in cancer prevention and cancer promotion","volume":"2019","author":"Wong","year":"2019","journal-title":"Adv Pharmacol Sci"},{"key":"2025120520361774000_14.4.e082414.22","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.3337"},{"key":"2025120520361774000_14.4.e082414.23","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-0666"},{"key":"2025120520361774000_14.4.e082414.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.plipres.2018.06.001"},{"key":"2025120520361774000_14.4.e082414.25","doi-asserted-by":"crossref","DOI":"10.1155\/2013\/823849","article-title":"Serum lipid profiles and cancer risk in the context of obesity: four meta-analyses","volume":"2013","author":"Melvin","year":"2013","journal-title":"J Cancer Epidemiol"},{"key":"2025120520361774000_14.4.e082414.26","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-15-2613"},{"key":"2025120520361774000_14.4.e082414.27","doi-asserted-by":"crossref","DOI":"10.1136\/jitc-2020-000964","article-title":"Genetic ablation of Adipocyte PD-L1 reduces tumor growth but accentuates obesity-associated inflammation","volume":"8","author":"Wu","year":"2020","journal-title":"J Immunother Cancer"},{"key":"2025120520361774000_14.4.e082414.28","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1007\/s13577-024-01029-2","article-title":"PDL-1 and insulin resistance in obesity: a possible pathway for Macrovascular disease","volume":"37","author":"Abdalla","year":"2024","journal-title":"Hum Cell"},{"key":"2025120520361774000_14.4.e082414.29","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2018.00715","article-title":"HDL in endocrine Carcinomas: biomarker, drug carrier, and potential therapeutic","volume":"9","author":"Morin","year":"2018","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2025120520361774000_14.4.e082414.30","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.2174\/0929867325666180530110543","article-title":"Biological consequences of dysfunctional HDL","volume":"26","author":"Pirillo","year":"2019","journal-title":"Curr Med Chem"},{"key":"2025120520361774000_14.4.e082414.31","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.3390\/biomedicines9091083","article-title":"Is a high HDL-cholesterol level always beneficial","volume":"9","author":"Franczyk","year":"2021","journal-title":"Biomedicines"},{"key":"2025120520361774000_14.4.e082414.32","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.110.207977"},{"key":"2025120520361774000_14.4.e082414.33","unstructured":"International Agency for Research on Cancer . IARC monographs on the identification of carcinogenic hazards to humans; world health organization. 2023. Available: https:\/\/monographs.iarc.who.int\/agents-classified-by-the-iarc\/"},{"key":"2025120520361774000_14.4.e082414.34","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-006-0111-z"},{"key":"2025120520361774000_14.4.e082414.35","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.4254\/wjh.v7.i16.1974","article-title":"Role of systemic inflammation in cirrhosis: from pathogenesis to prognosis","volume":"7","author":"Dirchwolf","year":"2015","journal-title":"WJH"},{"key":"2025120520361774000_14.4.e082414.36","doi-asserted-by":"crossref","DOI":"10.1016\/j.cbi.2022.110141","article-title":"Gata3 as an Immunomodulator in obesity-related metabolic dysfunction associated with fatty liver disease, insulin resistance, and type 2 diabetes","volume":"366","author":"El-Arabey","year":"2022","journal-title":"Chem Biol Interact"},{"key":"2025120520361774000_14.4.e082414.37","doi-asserted-by":"crossref","DOI":"10.1016\/j.jhepr.2021.100249","article-title":"From congestive Hepatopathy to hepatocellular carcinoma, how can we improve patient management","volume":"3","author":"Sessa","year":"2021","journal-title":"JHEP Rep"},{"key":"2025120520361774000_14.4.e082414.38","doi-asserted-by":"crossref","DOI":"10.3390\/cancers15030729","article-title":"Multifactorial diseases of the heart, kidneys, lungs, and liver and incident cancer: epidemiology and shared mechanisms","volume":"15","author":"Shi","year":"2023","journal-title":"Cancers (Basel)"},{"key":"2025120520361774000_14.4.e082414.39","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2011-0462"},{"key":"2025120520361774000_14.4.e082414.40","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ejca.2015.09.027","article-title":"Use of metformin and risk of kidney cancer in patients with type 2 diabetes","volume":"52","author":"Tseng","year":"2016","journal-title":"Eur J Cancer"},{"key":"2025120520361774000_14.4.e082414.41","doi-asserted-by":"crossref","DOI":"10.1186\/s12967-023-04263-8","article-title":"Metformin and cancer hallmarks: shedding new lights on therapeutic Repurposing","volume":"21","author":"Hua","year":"2023","journal-title":"J Transl Med"},{"key":"2025120520361774000_14.4.e082414.42","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1055\/s-0039-1679956","article-title":"Prevention of hepatocellular carcinoma by Statins: clinical evidence and plausible mechanisms","volume":"39","author":"Kim","year":"2019","journal-title":"Semin Liver Dis"},{"key":"2025120520361774000_14.4.e082414.43","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/94.4.252"},{"key":"2025120520361774000_14.4.e082414.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2003.11.007"},{"key":"2025120520361774000_14.4.e082414.45","first-page":"877","article-title":"Anticoagulants and cancer mortality in the Finnish randomized study of screening for prostate cancer","volume":"30","author":"Kinnunen","year":"2019","journal-title":"Cancer Causes Control"},{"key":"2025120520361774000_14.4.e082414.46","doi-asserted-by":"crossref","DOI":"10.1038\/ctg.2016.16","article-title":"Lower gastrointestinal bleeding and risk of gastrointestinal cancer","volume":"7","author":"Viborg","year":"2016","journal-title":"Clin Transl Gastroenterol"},{"key":"2025120520361774000_14.4.e082414.47","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.18632\/aging.102699","article-title":"Antihypertensive medications are associated with the risk of kidney and bladder cancer: a systematic review and meta-analysis","volume":"12","author":"Xie","year":"2020","journal-title":"Aging"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-082414","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T04:36:28Z","timestamp":1764995788000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-082414"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":47,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,3]]},"published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1136\/bmjopen-2023-082414"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-082414","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]}}}