Researchers have found that a blood test may effectively identify patients with type 2 diabetes who may be at a higher risk of developing certain cancers, according to new findings to be presented by Bennetsen et al at the upcoming European Association for the Study of Diabetes Annual Meeting 2024 (Abstract 1026).
Background
Patients with type 2 diabetes are known to be more likely to develop obesity-related cancers—including breast cancer, renal cell carcinoma, endometrial cancer, thyroid cancer, and ovarian cancer—multiple myeloma, and gastrointestinal cancers such as colorectal cancer and pancreatic cancer. Research indicates that chronic low-grade inflammation, which is prevalent in both obesity and type 2 diabetes, may play a significant role in cancer development in both conditions. Proinflammatory cytokines are immune system proteins that heighten inflammation.
“Understanding which [patients] are at higher risk for these cancers would allow for more targeted and effective monitoring and early detection, potentially improving outcomes through earlier intervention and personalized treatment,” emphasized lead study author Mathilde Dahlin Bennetsen, of the Steno Diabetes Center Odense at the Odense University Hospital in Denmark.
Study Methods and Results
In the study, the researchers examined whether differences in proinflammatory cytokine levels could help predict the risk of obesity-related cancers in 6,466 patients with a median age of 60.9 years who had recently been diagnosed with type 2 diabetes. They noted that 40.5% of the patients identified as female.
The researchers measured levels of the proinflammatory cytokines interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, and high sensitivity C-reactive proteins at baseline. They noted that IL-6 and TNF-alpha are released by adipose tissue and are often found at higher levels in patients with type 2 diabetes. They then grouped the participants into three categories based on their IL-6 levels: the lowest third with IL-6 levels below 0.94 pg/mL, the middle third with levels between 0.94 and 1.58 pg/mL, and the highest third with levels greater than 1.58 pg/mL.
After a follow-up of 8.8 years, the researchers found that 327 of the patients developed obesity-related cancers. A higher level of IL-6 at baseline was associated with a greater risk of developing obesity-related cancers. When the results were adjusted for age, sex, diabetes duration, alcohol consumption, waist circumference, physical activity, HbA1C, triglyceride levels, use of lipid-lowering drugs, and use of diabetes drugs, the patients in the highest third group had a 51% higher risk of developing an obesity-related cancer compared with those in the lowest third group.
Additionally, TNF-alpha and high sensitivity C-reactive proteins were only weakly associated with obesity-related cancers compared with IL-6. Factoring in smoking status did not alter the results. When the researchers added baseline IL-6 levels to other factors known to increase the risk of obesity-related cancers, it led to a small but significant increase in the ability to predict whether a patient would later develop obesity-related cancer. In contrast, the inclusion of TNF-alpha or high sensitivity C-reactive proteins did not improve the predictive models.
Conclusions
The researchers concluded that higher IL-6 levels may be associated with the development of obesity-related cancers in patients newly diagnosed with type 2 diabetes. Their findings suggested that a simple blood test could identify those at higher risk of cancer. However, further research is needed to determine whether testing would improve the early detection and management of these cancers.
“Understanding that higher levels of inflammation can indicate a greater risk of certain cancers highlights the importance of regular check-ups and effective diabetes management. Maintaining a healthy lifestyle and adhering to treatment plans can potentially help manage inflammation and reduce cancer risk,” Ms. Bennetsen concluded.
Disclosure: For full disclosures of the study authors, visit easd.org.
