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- Title
Identifying clinical factors associated with an increased risk of Diabetes Mellitus among cancer survivors.
- Authors
Tashakkor, Amir Yashar; Moghaddamjou, Ali; Birks, Peter; Cheung, Winson Y.
- Abstract
Background: In order to ensure that the survival gains from cancer advances are not lost because of competing health risks, quality preventive care should be an essential aspect during the routine follow-up of cancer survivors (CS). The ability to identify CS who are most at risk for potentially modifiable conditions, such as diabetes mellitus (DM), can help to streamline preventive efforts. Our objectives were to 1) identify clinical factors associated with an increased risk of DM among CS and 2) develop a stratification system to predict DM risk in CS. Methods: Using the US National Health and Nutrition Examination Survey, we identified 26,206 patients: 2,374 CS and 23,832 non-cancer controls (NCC). Multivariate logistic regression models were developed to determine demographic characteristics and clinical parameters that were independently correlated with an elevated relative risk (RR) of DM. By assigning a score of 1 for each diabetic risk factor identified, a stratification system was constructed that estimated the prevalence of DM based on the risk score. Results: In the entire cohort, mean age of 45.0 years (SD 17.4), 51.9 % were female, and 88.6% were White. Baseline characteristics were comparable between CS and NCC. DM was significantly more prevalent in CS when compared to NCC (13.2% of CS vs. 6.9% of NCC, p<0.01). Multivariate analyses revealed the following risk factors for DM: age = 60 (RR 2.19, 95% CI 1.78-2.70); racial minorities (RR 1.65, 95% CI 1.16-2.33); less than high school education (RR 1.87, 95% CI 1.33-2.64); obesity (RR 5.90, 95% CI 4.88-7.14); history of ischemic heart disease (RR 2.20, 95% CI 1.45-3.33); history of congestive heart failure (RR 2.95, 95% CI 1.51-5.77); systolic blood pressure =120 mmHg (RR 1.66, 95% CI 1.22- 2.26); and triglyceride level =150 mg/dL (RR 1.49, 95% CI 1.10-2.03). A stratification schema for DM in CS was devised (see Table). Conclusions: Through the identification of risk factors for DM, a simple stratification schema was developed, allowing for the identification of CS who may benefit most from appropriate DM preventive care.
- Publication
UBC Medical Journal, 2011, Vol 2, Issue 2, p74
- ISSN
1920-7425
- Publication type
Academic Journal