Endogenous incretin levels and risk of first incident cancer: a prospective cohort study

Author:

Jujić Amra,Godina Christopher,Belting Mattias,Melander Olle,Juul Holst Jens,Ahlqvist Emma,Gomez Maria F.,Nilsson Peter M.,Jernström Helena,Magnusson Martin

Abstract

AbstractConcerns have been raised regarding a potentially increased risk of cancer associated with treatment with glucagon-like peptide-1 (GLP-1) receptor agonists. Here, we explored whether fasting and oral glucose tolerance test post-challenge glucose-dependent insulinotropic peptide (GIP) and GLP-1 levels were associated with incident first cancer. Within the cardiovascular re-examination arm of the population-based Malmö Diet Cancer study (n = 3734), 685 participants with a previous cancer diagnosis were excluded, resulting in 3049 participants (mean age 72.2 ± 5.6 years, 59.5% women), of whom 485 were diagnosed with incident first cancer (median follow-up time 9.9 years). Multivariable Cox-regression and competing risk regression (death as competing risk) were used to explore associations between incretin levels and incident first cancer. Higher levels of fasting GLP-1 (462 incident first cancer cases/2417 controls) showed lower risk of incident first cancer in competing risk regression (sub-hazard ratio 0.90; 95% confidence interval 0.82–0.99; p = 0.022). No association was seen for fasting GIP, post-challenge GIP, or post-challenge GLP-1 and incident first cancer. In this prospective study, none of the fasting and post-challenge levels of GIP and GLP-1 were associated with higher risk of incident first cancer; by contrast, higher levels of fasting GLP-1 were associated with lower risk of incident first cancer.

Funder

Lunds Universitet

Region Skåne

Medicinska Fakulteten, Lunds Universitet

Vetenskapsrådet

Hjärt-Lungfonden

Crafoordska Stiftelsen

Sydvästra Skånes Diabetesförening

Direktör Albert Påhlssons Stiftelse

Ernhold Lundströms stiftelse

Knut och Alice Wallenbergs Stiftelse

Novo Nordisk Foundation Center for Basic Metabolic Research

Stiftelsen för Strategisk Forskning

Skånes universitetssjukhus

Hulda och E Conrad Mossfelts Stiftelse för Vetenskaplig Forskning Inom Hjärt- och Kärlsjukdomarnas Område

Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse

Marcus Wallenbergs Stiftelse för Internationellt Vetenskapligt Samarbete

Lund University

Publisher

Springer Science and Business Media LLC

Subject

Multidisciplinary

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