{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T16:24:03Z","timestamp":1787934243145,"version":"build-2784847793"},"reference-count":55,"publisher":"Korean Diabetes Association","issue":"1","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Special Foundation for Science and Technology Basic Research Program","award":["2019FY101103"],"award-info":[{"award-number":["2019FY101103"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81941019"],"award-info":[{"award-number":["81941019"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Hong Kong Foundation for Educational Development and Research","award":["SN\/1f\/HKUF-DC; C20400.28505200"],"award-info":[{"award-number":["SN\/1f\/HKUF-DC; C20400.28505200"]}]},{"name":"Health Medical Research Fund","award":["HMRF\/13143241"],"award-info":[{"award-number":["HMRF\/13143241"]}]},{"name":"Guangzhou Public Health Bureau","award":["201102A211004011"],"award-info":[{"award-number":["201102A211004011"]}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong","doi-asserted-by":"crossref","award":["2018A030313140"],"award-info":[{"award-number":["2018A030313140"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000855","name":"University Of Birmingham","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000855","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-dmj.org"],"crossmark-restriction":true},"short-container-title":["Diabetes Metab J"],"published-print":{"date-parts":[[2024,1,31]]},"abstract":"<jats:p>Background: Abnormal glucose metabolism is a risk factor for colorectal cancer (CRC). However, association of glycosylated hemoglobin (HbA1c) with CRC risk remains under-reported. We examined the association between glycemic indicators (HbA1c, fasting plasma glucose, fasting insulin, 2-hour glucose, 2-hour insulin, and homeostasis model of risk assessment-insulin resistance index) and CRC risk using prospective analysis and meta-analysis.Methods: Participants (&lt;i&gt;n&lt;\/i&gt;=1,915) from the Guangzhou Biobank Cohort Study-Cardiovascular Disease Substudy were included. CRC events were identified through record linkage. Cox regression was used to assess the associations of glycemic indicators with CRC risk. A meta-analysis was performed to investigate the association between HbA1c and CRC risk.Results: During an average of 12.9 years follow-up (standard deviation, 2.8), 42 incident CRC cases occurred. After adjusting for potential confounders, the hazard ratio (95% confidence interval [CI]) of CRC for per % increment in HbA1c was 1.28 (95% CI, 1.01 to 1.63) in overall population, 1.51 (95% CI, 1.13 to 2.02) in women and 1.06 (95% CI, 0.68 to 1.68) in men. No significant association of other measures of glycemic indicators and baseline diabetes with CRC risk was found. Meta-analyses of 523,857 participants including our results showed that per % increment of HbA1c was associated with 13% higher risk of CRC, with the pooled risk ratio being 1.13 (95% CI, 1.01 to 1.27). Subgroupanalyses found stronger associations in women, colon cancer, Asians, and case-control studies.Conclusion: Higher HbA1c was a significant predictor of CRC in the general population. Our findings shed light on the pathology of glucose metabolism and CRC, which warrants more in-depth investigation.<\/jats:p>","DOI":"10.4093\/dmj.2022.0383","type":"journal-article","created":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T08:13:30Z","timestamp":1704356010000},"page":"134-145","update-policy":"https:\/\/doi.org\/10.4093\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association of Measures of Glucose Metabolism with Colorectal Cancer Risk in Older Chinese: A 13-Year Follow-up of the Guangzhou Biobank Cohort Study-Cardiovascular Disease Substudy and Meta-Analysis"],"prefix":"10.4093","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6768-2550","authenticated-orcid":true,"given":"Shu Yi","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6691-4409","authenticated-orcid":true,"given":"Wei Sen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao Qiang","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya Li","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0537-922X","authenticated-orcid":true,"given":"Lin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2567","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"ref2","first-page":"627","volume-title":"Global, regional, and national burden of colorectal cancer and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","year":"2022"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2021.09.034"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20078"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1038\/s41568-020-0295-5"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011430"},{"key":"ref7","first-page":"624","volume-title":"Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331,288 participants","year":"2015"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.14.1545"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyl131"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2009.52"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/bf00280883"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-s002"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.727727"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2021.02.006"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-01421"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i17.5167"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/91.13.1147"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr029"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2016.01.004"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2017.02.004"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000803"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-0710"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwy208"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.84.s1.03"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2006.04.015"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s00394-020-02416-9"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.12.035"},{"key":"ref28","first-page":"303","volume-title":"Reliability and validity of the IPAQ-Chinese: the Guangzhou Biobank Cohort study","author":"Deng","year":"2008"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/s0271-5317(97)00170-x"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.192644"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.7326\/acpjc-1995-123-3-a12"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwj141"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1309\/lm3duseibxhtvz70"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116237"},{"key":"ref36","first-page":"412","volume-title":"Association of markers of insulin and glucose control with subsequent colorectal cancer risk","author":"Saydah","year":"2003"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.epi-04-0661"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.epi-08-0495"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.27394"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29917"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.epi-19-1623"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0803713"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.915.13.6"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.epi-05-0533"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdm135"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-9033"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2014.150"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.01.057"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/1747326"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1007\/s12672-010-0020-z"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.552283"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32310"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.12659\/msm.916719"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1093\/nutrit\/nuaa040"},{"key":"ref55","first-page":"2323","volume-title":"Reduced risk of colorectal cancer with metformin therapy in patients with type 2 diabetes: a meta-analysis","author":"Zhang","year":"2011"}],"container-title":["Diabetes &amp; Metabolism Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-dmj.org\/upload\/pdf\/dmj-2022-0383.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-dmj.org\/journal\/view.php?doi=10.4093\/dmj.2022.0383","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-dmj.org\/upload\/pdf\/dmj-2022-0383.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:09:03Z","timestamp":1707091743000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-dmj.org\/journal\/view.php?doi=10.4093\/dmj.2022.0383"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,31]]},"references-count":55,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"URL":"https:\/\/doi.org\/10.4093\/dmj.2022.0383","relation":{},"ISSN":["2233-6079","2233-6087"],"issn-type":[{"value":"2233-6079","type":"print"},{"value":"2233-6087","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,31]]},"assertion":[{"value":"2022-10-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-03","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-31","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}