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Slouha E, Gates KM, Al-Geizi H, Baah E, Clunes LA, Kollias TF. The Relationship Between Gestational Diabetes and the Risk of Cancer: A Systematic Review. Cureus 2024; 16:e53328. [PMID: 38435884 PMCID: PMC10906975 DOI: 10.7759/cureus.53328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is one of the most common endocrine disorders to occur during pregnancy due to the increase in circulating human placental lactogen (hPL) and possible beta-cell sensitivity. While GDM can be managed either with diet and exercise or pharmacological interventions, it is associated with significant maternal and neonatal complications. Maternal complications include short- and long-term conditions such as pre-eclampsia, preterm birth, arrest of labor, future development of type 2 diabetes mellitus (T2DM), and cardiovascular disorders. Neonates can develop hypoglycemia and hypocalcemia and have a large gestational age (LGA). New research has also highlighted another possible long-term complication for both mothers and offspring, which is the development of cancer. Cancer has various types of progression, but most cause systemic symptoms leading to a reduced quality of life. Cancer can be terminal and can affect the majority of the population; thus, significant effort is being employed to try and reduce its occurrence. This systematic review was conducted with adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using PubMed, ScienceDirect, and ProQuest databases. Initially, 136,019 publications were identified. Through the screening process, a total of 27 publications were finalized within the scope of this paper. Most studies observing maternal cancer with a history of GDM found that there was an association between the increased risk of cancer and GDM. Specifically, these studies identified the association of GDM with breast, ovarian, cervical, and uterine cancer, as well as other non-reproductive organs such as the thyroid and pancreas. Cancer development in the offspring also presented an association with mothers who developed GDM. The most prevalent cancer evaluated was leukemia, and it was specifically associated with a maternal history of GDM. With the consistent rise in the incidence of cancer, any attempts to reduce its development are imperative to assess. While GDM is essentially a temporary condition that resolves following pregnancy in most patients, the possibility of contributing to future conditions years after its occurrence creates a sense of urgency and necessity to reduce the incidence of GDM. Researchers should be able to identify other unknown biomarkers that contribute to the development of cancer in mothers who experienced GDM as well as their infants.
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Affiliation(s)
- Ethan Slouha
- Anatomical Sciences, St. George's University School of Medicine, St. George's, GRD
| | - Kaitlyn M Gates
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Hanin Al-Geizi
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Esther Baah
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Lucy A Clunes
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Theofanis F Kollias
- Microbiology, Immunology, and Pharmacology, St. George's University School of Medicine, St. George's, GRD
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Huang X, Hansen J, Lee PC, Wu CK, Federman N, Arah OA, Li CY, Olsen J, Ritz B, Heck JE. Maternal diabetes and childhood cancer risks in offspring: two population-based studies. Br J Cancer 2022; 127:1837-1842. [PMID: 36088507 PMCID: PMC9643384 DOI: 10.1038/s41416-022-01961-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The effect of maternal diabetes on childhood cancer has not been widely studied. METHODS We examined this in two population-based studies in Denmark (N = 6420 cancer cases, 160,484 controls) and Taiwan (N = 2160 cancer cases, 2,076,877 non-cases) using logistic regression and Cox proportional hazard regression adjusted for birth year, child's sex, maternal age and birth order. RESULTS Gestational diabetes in Denmark [odds ratio (OR) = 0.98, 95% confidence interval (CI): 0.71-1.35] or type II and gestational diabetes in Taiwan (type II: hazard ratio (HR) = 0.81, 95% CI: 0.63-1.05; gestational diabetes: HR = 1.06, 95% CI: 0.92-1.22) were not associated with cancer (all types combined). In Denmark, maternal type I diabetes was associated with the risk of glioma (OR = 2.33, 95% CI: 1.04-5.22), while in Taiwan, the risks of glioma (HR = 1.59, 95% CI: 1.01-2.50) were elevated among children whose mothers had gestational diabetes. There was a twofold increased risk for hepatoblastoma with maternal type II diabetes (HR = 2.02, 95% CI: 1.02-4.00). CONCLUSIONS Our results suggest that maternal diabetes is an important risk factor for certain types of childhood cancers, emphasising the need for effective interventions targeting maternal diabetes to prevent serious health effects in offspring.
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Affiliation(s)
- Xiwen Huang
- Department of Epidemiology, Fielding School of Public Health, and Jonsson Comprehensive Cancer Center, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095-1772, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen, Denmark
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, 89 Nei-Chiang St, Wan-Hua Dist, Taipei, 10845, Taiwan.
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Team "Exposome, heredity, cancer and health", CESP, 94807, Villejuif, France.
- Department of Public Health, National Cheng Kung University, #1, University Road, Tainan, 70101, Taiwan.
| | - Chia-Kai Wu
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Team "Exposome, heredity, cancer and health", CESP, 94807, Villejuif, France
| | - Noah Federman
- Department of Pediatrics, Geffen School of Medicine, UCLA, Los Angeles, CA, 90095-1752, USA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, and Jonsson Comprehensive Cancer Center, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095-1772, USA
- Department of Statistics, UCLA College of Letters and Science, Los Angeles, CA, USA
- Section for Epidemiology, Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Chung-Yi Li
- Department of Public Health, National Cheng Kung University, #1, University Road, Tainan, 70101, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Olof Palmes Allé 43-45 8200 Aarhus N, Aarhus, Denmark
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, and Jonsson Comprehensive Cancer Center, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095-1772, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, and Jonsson Comprehensive Cancer Center, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095-1772, USA.
- College of Health and Public Service, University of North Texas, 1155 Union Circle #305250, Denton, TX, 76203-5017, USA.
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3
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Marcoux S, Côté-Corriveau G, Healy-Profitós J, Auger N. Varying Impact of Gestational Diabetes Mellitus on Incidence of Childhood Cancers: An Age-Stratified Retrospective Cohort Study. Diabetes Care 2022; 45:1177-1183. [PMID: 35262645 DOI: 10.2337/dc21-2107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/06/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We studied the association between gestational diabetes mellitus and early versus late childhood cancer. RESEARCH DESIGN AND METHODS We conducted a retrospective cohort study of 1 million children born between 2006 and 2019 in Quebec, Canada. We identified children who were exposed to gestational diabetes mellitus in utero and followed them from birth up to 14 years of age to identify new-onset cancers. We estimated hazard ratios (HRs) for the association between gestational diabetes mellitus and childhood cancer using Cox proportional regression models with adjustment for covariates through inverse propensity score weights. RESULTS A total of 83,626 children (8.2%) were exposed to gestational diabetes mellitus, and 1,702 developed cancer during 7.6 million person-years of follow-up. Children exposed to gestational diabetes mellitus had a higher risk of any cancer (HR 1.19, 95% CI 1.01-1.40), with signals present for blood cancer (HR 1.27, 95% CI 0.92-1.76) and solid tumors (HR 1.14, 95% CI 0.94-1.40). The association between gestational diabetes mellitus and cancer was strongest early in life and decreased with age. Gestational diabetes mellitus was associated with 1.47 times the risk of any cancer (95% CI 1.21-1.79), 1.44 times the risk of solid cancer (95% CI 1.12-1.87), and 1.61 times the risk of blood cancer (95% CI 1.09-2.36) in children age <2 years. Gestational diabetes mellitus was not significantly associated with blood or solid cancers after 2 years of age, and all associations disappeared after 6 years. CONCLUSIONS Hyperglycemia may be carcinogenic in utero and may be a novel risk factor for early childhood cancer.
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Affiliation(s)
- Sophie Marcoux
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.,University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | | | - Jessica Healy-Profitós
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada.,Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Nathalie Auger
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada.,Institut national de santé publique du Québec, Montreal, Quebec, Canada.,Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
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4
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Marley AR, Domingues A, Ghosh T, Turcotte LM, Spector LG. Maternal BMI, Diabetes, and Gestational Weight Gain and Risk for Pediatric Cancer in Offspring: A Systematic Review and Meta-Analysis. JNCI Cancer Spectr 2022; 6:6537542. [PMID: 35603850 PMCID: PMC8982388 DOI: 10.1093/jncics/pkac020] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background Pediatric cancer incidence has steadily increased concurrent with rising adult obesity, but associations between maternal obesity and associated comorbidities and pediatric cancer risk remain understudied. We aimed to quantitatively characterize associations of pediatric cancer risk with maternal prepregnancy body mass index (BMI), gestational weight gain, and maternal diabetes. Methods We performed a comprehensive and systematic literature search in Ovid and EMBASE from their inception to March 15, 2021. Eligible studies reported risk estimates and sample sizes and provided sufficient description of outcome and exposure ascertainment. Random effects models were used to estimate pooled effects. Results Thirty-four studies were included in the analysis. Prepregnancy BMI was positively associated with leukemia risk in offspring (odds ratio [OR] per 5-unit BMI increase =1.07, 95% confidence intervals [CI] = 1.04 to 1.11; I2 = 0.0%). Any maternal diabetes was positively associated with acute lymphoblastic leukemia risk (OR = 1.46, 95% CI = 1.28 to 1.67; I2 = 0.0%), even after restricting to birthweight-adjusted analyses (OR = 1.74, 95% CI = 1.29 to 2.34; I2 = 0.0%), and inversely associated with risk of central nervous system tumors (OR = 0.73, 95% CI = 0.55 to 0.97; I2 = 0.0%). Pregestational diabetes (OR = 1.57, 95% CI = 1.11 to 2.24; I2 = 26.8%) and gestational diabetes (OR = 1.40, 95% CI = 1.12 to 1.75; I2 = 0.0%) were also positively associated with acute lymphoblastic leukemia risk. No statistically significant associations were observed for gestational weight gain. Conclusions Maternal obesity and diabetes may be etiologically linked to pediatric cancer, particularly leukemia and central nervous system tumors. Our findings support weight management and glycemic control as important components of maternal and offspring health. Further validation is warranted.
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Affiliation(s)
- Andrew R Marley
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Allison Domingues
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Taumoha Ghosh
- Division of Hematology/Oncology, Department of Pediatrics, University of Miami, Miami, FL, USA
| | - Lucie M Turcotte
- Division of Hematology/Oncology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
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Yan P, Wang Y, Yu X, Liu Y, Zhang ZJ. Maternal diabetes and risk of childhood malignancies in the offspring: a systematic review and meta-analysis of observational studies. Acta Diabetol 2021; 58:153-168. [PMID: 32915298 DOI: 10.1007/s00592-020-01598-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/20/2020] [Indexed: 01/19/2023]
Abstract
AIMS Diabetes mellitus (DM) is widely recognized as a risk factor for diverse cancers in adults. However, the association between maternal diabetes and risk of childhood cancer in the offspring has so far not been well studied. We thus conducted a meta-analysis to evaluate the role of maternal diabetes on the risk of childhood cancer. METHODS We performed a comprehensive literature search to identify eligible studies published up to June 20, 2020, including the PubMed, Web of science and Embase databases. Summary odds ratios (OR) and 95% confidence intervals (CI) were computed using a random-effects model (I2 ≥ 25%) or a fixed-effect model (I2 < 25%). RESULTS Totally, sixteen case-control and six cohort studies on the risk of childhood cancer associated with maternal diabetes were included. Overall, children of diabetic women had a significantly increased risk in childhood malignancy (OR, 1.30; 95% CI, 1.10-1.53). Notably, a significantly elevated risk of childhood cancer in the offspring was found for women with pre-existing diabetes (OR, 1.41; 95% CI, 1.17-1.70), but not for women with gestational diabetes mellitus (GDM) (OR, 1.10; 95% CI, 0.94-1.28). For site-specific cancers, maternal diabetes was associated with a higher risk of leukemia in offspring (OR, 1.30; 95% CI, 1.15-1.48), especially for acute lymphoblastic leukemia (OR, 1.44; 95% CI, 1.27-1.64). However, no significant associations were observed between maternal diabetes and the risk of lymphomas and retinoblastoma. CONCLUSIONS Our meta-analysis indicates that maternal diabetes is associated with an increased risk of childhood cancer in the offspring, particularly for acute lymphoblastic leukemia. Future study should investigate the underlying biological mechanisms behind the association.
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Affiliation(s)
- Pengfei Yan
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yongbo Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Xue Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yu Liu
- Department of Statistics and Management, School of Management, Wuhan Institute of Technology, Wuhan, 430205, China
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China.
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Ording AG, Christensen LB, Bjørge T, Doody DR, Ekbom A, Glimelius I, Grotmol T, Larfors G, Mueller BA, Smedby KE, Tretli S, Troisi R, Sørensen HT. Birthweight and all-cause mortality after childhood and adolescent leukemia: a cohort of children with leukemia from Denmark, Norway, Sweden, and Washington State. Acta Oncol 2020; 59:949-958. [PMID: 32174251 DOI: 10.1080/0284186x.2020.1738546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: High birthweight may predispose children to acute lymphoid leukemia, whereas low birthweight is associated with childhood morbidity and mortality. Low and high birthweight have been inconsistently associated with mortality in children with leukemia.Material and methods: In a cohort of childhood and adolescent leukemia (0-19 years) patients from registries in Denmark, Norway, Sweden, and Washington State in the United States (1967-2015), five-year all-cause mortality was assessed by birthweight and other measures of fetal growth using the cumulative incidence function and Cox regression with adjustment for sex, diagnosis year, country, the presence of Down's syndrome or other malformations, and type of leukemia.Results: Among 7148 children and adolescents with leukemia (55% male), 4.6% were low (<2500 g) and 19% were high (≥4000 g) birthweight. Compared with average weight, hazard ratios (HRs) of death associated with low birthweight varied by age at leukemia diagnosis: 1.5 (95% confidence interval (CI): 0.7, 3.2) for patients 0-1 year old, 1.6 (95% CI: 1.0, 2.6) for >1-2 years old; 1.0 (95% CI: 0.6, 1.5) for 3-8 years old; 1.0 (95% CI: 0.6, 1.8) for 9-13 years old; and 1.2 (95% CI: 0.7, 2.1) for 14-19 years old, and were similar for size for gestational age and Ponderal index. In analyses restricted to children born full term (37-41 weeks of gestation), results were only slightly attenuated but risk was markedly increased for infants aged ≤1 year (HR for low birthweight = 3.2, 95% CI: 1.2, 8.8).Conclusion: This cohort study does not suggest that low birthweight or SGA is associated with increased five-year all-cause mortality risk among children with any type of childhood leukemia or acute lymphoblastic leukemia, specifically, beyond infancy.
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Affiliation(s)
- Anne Gulbech Ording
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - David R. Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Anders Ekbom
- Department of Medicine Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Glimelius
- Department of Medicine Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | | | - Gunnar Larfors
- Department of Medical Sciences, Unit of Hematology, Uppsala University, Uppsala, Sweden
| | - Beth A. Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Karin E. Smedby
- Department of Medicine Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | | | - Rebecca Troisi
- Division of Cancer Epidemiology and Biostatistics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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Lupo PJ, Spector LG. Cancer Progress and Priorities: Childhood Cancer. Cancer Epidemiol Biomarkers Prev 2020; 29:1081-1094. [DOI: 10.1158/1055-9965.epi-19-0941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 12/18/2019] [Accepted: 03/09/2020] [Indexed: 11/16/2022] Open
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8
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Seppälä LK, Vettenranta K, Pitkäniemi J, Hirvonen E, Leinonen MK, Madanat-Harjuoja LM. Maternal diabetes and risk of childhood cancer in the offspring. Int J Cancer 2019; 147:662-668. [PMID: 31658368 DOI: 10.1002/ijc.32757] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 10/21/2019] [Indexed: 01/10/2023]
Abstract
An association between maternal diabetes, its medication and childhood cancer has not been previously explored in a registry-based setting. With a case-control design, we aimed to explore whether maternal diabetes is associated with an increased risk of childhood cancer in the offspring. Combining data from population-based registries, we analyzed a total of 2,029 cases, that is, persons with childhood cancer diagnosed under the age of 20 years between years 1996-2014 and a total of 10,103 matched population controls. The mothers of the cases/controls and their diagnoses of diabetes (DM) before/during pregnancy as well as their insulin/metformin prescriptions during pregnancy were identified. Conditional logistic regression modeling was used to analyze the risk of childhood cancer. The OR for childhood cancer among those exposed to any maternal diabetes was 1.32 (95% CI 1.14-1.54) compared to the offspring of the nondiabetic mothers. The effect of maternal diabetes on the risk of childhood cancer remained elevated even after adjusting for maternal age, parity and smoking. Our data suggest that maternal diabetes medication may reduce the risk for childhood cancer (adjusted OR 0.83, 95% CI 0.36-1.94), especially in gestational diabetes (adjusted OR 0.26, 95% CI 0.05-1.25), compared to the diabetic mothers without medication. The risk of childhood leukemia was significantly higher among children exposed to any maternal diabetes (OR 1.36, CI 1.04-1.77) compared to the unexposed. Maternal diabetes appears to be associated with an increased risk of childhood cancer in the offspring. The possible risk-reducing effect of an exposure to diabetes medication on offspring cancer risk warrants further investigation.
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Affiliation(s)
- Laura K Seppälä
- Pediatric Research Center, University of Helsinki, Helsinki, Finland.,The New Children's Hospital, University of Helsinki Hospital for Children and Adolescents, Helsinki, Finland
| | - Kim Vettenranta
- Pediatric Research Center, University of Helsinki, Helsinki, Finland.,The New Children's Hospital, University of Helsinki Hospital for Children and Adolescents, Helsinki, Finland.,Finnish Red Cross Blood Service, Helsinki, Finland
| | - Janne Pitkäniemi
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.,Faculty of Social Sciences, School of Health Sciences, University of Tampere, Tampere, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Elli Hirvonen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Maarit K Leinonen
- Information Services Department, Unit of Statistics and Registers, National Institute for Health and Welfare, Helsinki, Finland
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9
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Mormile R. Childhood brain cancer risk from early life exposure to hyperinsulinemia in offspring of diabetic mothers: the exception that proves the rule? Minerva Pediatr (Torino) 2019; 73:89-90. [PMID: 31692309 DOI: 10.23736/s2724-5276.19.05582-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Raffaella Mormile
- Division of Pediatrics and Neonatology, Moscati Hospital, Aversa, Caserta, Italy -
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10
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Borsari L, Malagoli C, Della Torre F, Cellini M, Rodolfi R, Pession A, Vinceti M. Maternal pregestational diabetes and risk of acute lymphoblastic leukemia in the offspring: A population-based study in Northern Italy. Cancer Epidemiol 2019; 62:101572. [PMID: 31336345 DOI: 10.1016/j.canep.2019.101572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/09/2019] [Accepted: 07/14/2019] [Indexed: 01/07/2023]
Abstract
INTRODUCTION This population-based study aims to evaluate the association between maternal pregestational diabetes and risk of acute lymphoblastic leukemia (ALL) in the offspring. METHODS All 241,958 children born in three Northern Italy provinces 1998-2010 were followed from birth until first cancer diagnosis (National Childhood Cancer Register), age 15 years, or 31 December 2017. We computed hazard ratio (HR) and 95% CI of ALL in relation to the presence of maternal diabetes through Cox proportional regression models. RESULTS We observed 145 cases of ALL, with a higher incidence in children born to women with pregestational diabetes compared to the others (12.4 vs 4.6). Adjusted hazard ratio of ALL was 2.6 (CI, 0.6-10.5) for maternal diabetes. DISCUSSION We estimated higher risks of ALL in the offspring of women with pregestational diabetes. These results are consistent with previous findings and compatible with a role of prenatal glycaemic environment in childhood cancer aetiology.
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Affiliation(s)
- Lucia Borsari
- Environmental, Genetic and Nutritional Epidemiology Research Centre (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy.
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Centre (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy.
| | - Fiammetta Della Torre
- Department of Paediatrics, Sant'Orsola Hospital, University of Bologna, Via Giuseppe Massarenti, 9, 40138 Bologna, Italy.
| | - Monica Cellini
- Division of Paediatric Oncology-Haematology, Policlinico Hospital, Largo del Pozzo, 71, 41125 Modena, Italy.
| | - Rossella Rodolfi
- Local Health Authority of Reggio Emilia, Via Giovanni Amendola, 2, 42122 Reggio Emilia, Italy.
| | - Andrea Pession
- Department of Paediatrics, Sant'Orsola Hospital, University of Bologna, Via Giuseppe Massarenti, 9, 40138 Bologna, Italy.
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Centre (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy; Department of Epidemiology, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, United States.
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