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. 2022 Mar 29;22(1):345.
doi: 10.1186/s12885-022-09403-9.

Synergistic association between underweight and type 2 diabetes on the development of laryngeal cancer: a national population-based retrospective cohort study

Oh Hyeong Lee  1 , Yong-Moon Park  2 , Seung-Hyun Ko  3 , Kyuna Lee  4 , Yeonji Kim  1 , Kyungdo Han  5 , Jung-Hae Cho  6
Affiliations

Synergistic association between underweight and type 2 diabetes on the development of laryngeal cancer: a national population-based retrospective cohort study

Oh Hyeong Lee et al. BMC Cancer. .

Abstract

Background: Although cigarette smoking is the most significant risk factor for laryngeal cancer, other risk factors might also be associated with the development of laryngeal cancer. We investigated whether underweight and type 2 diabetes are associated with laryngeal cancer in a Korean population.

Methods: A total of 9,957,059 participants (≥20 years) without prior history of cancer who underwent a National Health Insurance Service health checkup in 2009 were followed up until December 31, 2018. Newly diagnosed laryngeal cancer was identified using claim data, and underweight was defined as body mass index (BMI) < 18.5 kg/m2. A Cox proportional-hazards models with multivariable adjustment were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs).

Results: During the median follow-up period of 8.3 years, 3504 cases of laryngeal cancer occurred. Underweight was associated with increased risk of laryngeal cancer after adjusting for potential confounders (HR: 1.43, 95% CI: 1.22-1.69) compared to those who were not underweight. Underweight and type 2 diabetes were synergistically associated with higher risk of laryngeal cancer (HR: 2.33, 95% CI: 1.54-3.51), compared to those without either condition. This relationship was stronger in those with an age < 65 years (HR: 3.33, 95% CI: 1.88-5.87) and alcohol consumption (HR: 2.72, 95% CI: 1.64-4.53).

Conclusions: These results suggest that underweight may be a significant risk factor for laryngeal cancer and that underweight and type 2 diabetes might synergistically increase the risk of laryngeal cancer.

Keywords: Body mass index; Cohort; Diabetes mellitus; Laryngeal cancer; Risk factors; Type 2 diabetes; Underweight.

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Conflict of interest statement

All authors declare no potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow chart of the cohort selection
Fig. 2
Fig. 2
Association between underweight, type 2 diabetes and the development of laryngeal cancer. The combination of underweight and type 2 diabetes showed a higher risk of laryngeal cancer. The analysis was adjusted for age, sex, smoking, alcohol consumption, regular physical activity, income, type 2 diabetes, hypertension, dyslipidemia, chronic kidney disease, and anemia
Fig. 3
Fig. 3
Forest plots including subgroup analyses for the association between participant characteristics and laryngeal cancer. Subgroup analyses were performed to investigate the associations between age, sex, smoking, alcohol consumption, and anemia and the development of laryngeal cancer according to the status of underweight and type 2 diabetes. The analysis was adjusted for age, sex, income, smoking, alcohol consumption, regular physical activity, hypertension, dyslipidemia, and anemia
See this image and copyright information in PMC

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