Meta-Analysis
Copyright ©2013 Baishideng Publishing Group Co.
World J Gastroenterol. Feb 14, 2013; 19(6): 936-945
Published online Feb 14, 2013. doi: 10.3748/wjg.v19.i6.936
Table 1 Characteristics of 15 studies included in the meta-analysis of the gastric cancer risk of preexisting diabetes
StudyStudy typeCountryDM criteriaAge (yr)Follow up (yr)Least interval1 (yr)SexDM prevalenceRR or OR (95%CI)Adjustment variables/matched variable of selectionNOS
Atchison et al[53]CSUnited States (veterans)Registration18-100271Male13.2%0.95 (0.89-1.02)Age, time, latency, race, number of visits, diagnoses of alcohol–related conditions, obesity and COPD8
Carstensen et al[19]CSDenmarkRegistrationNo limit15Not mentionedMale1.28 (1.15-1.43)Age, calendar time, date of birth8
Female1.34 (1.14-1.58)
Jiang et al[20]CCUnited StatesSelf reported30-741Both1.51 (1.10-2.07)2Age, sex, race, education, birth place, smoking and BMI7 (5)5
Lin et al[22]CSUnited StatesSelf reported50-71102Male9.9%1.52 (1.21-1.92)2Age, calories, alcohol consumption, smoking, fruit consumption, vegetable consumption, ethnicity, education, and physical activity8 (6)5
Female7.2%1.62 (0.98-2.68)2
Wotton et al[16]ORLS1CSEnglandRegistration≥ 30350Both5.5%1.11 (0.89-1.37)Sex, age in 5-year bands, time and district of residence8
ORLS294.0%2.05 (1.30-3.10)
Chodick et al[54]CSIsraelRegistration≥ 2180Male1.44 (0.98-2.11)Age, region, SES level, use of healthcare, BMI, and history of CVD/matched for age, sex8
Female0.99 (0.55-1.80)
Ikeda et al[37]CSJapanHbA1c (5.0%-5.9% vs 7.0%)≥ 4014Not mentionedBoth3.9%2.69 (1.24-5.85)Age, sex, H. pylori, history of peptic ulcer, BMI, TC, alcohol intake, smoking, dietary factor48
Ogunleye et al[55]CSScotlandRegistration (only type 2 DM)No limit111Both0.77 (0.36-1.66)Deprivation deciles of Carstairs/matched for age, sex and doctor practice8
Kuriki et al[29]CCJapanSelf reported40-80Not mentionedMale1.16 (0.93-1.44)Age, BMI, drinking, smoking, exercise, bowel movement, FHx of cancer and DM, dietary restriction, vegetable intake, greasy food, snack6
Female1.70 (1.16-2.48)
Inoue et al[27]CSJapanSelf reported40-69135Male6.7%1.09 (0.79-1.5)Age, study area, history of CVD and IHD, smoking, BMI, physical activity, alcohol, vegetable, coffee9
Female3.0%1.92 (1.06-3.47)
Jun et al[57]NCCKoreaFBS (< 99 mg/dL vs≥ 126 mg/dL)≥ 35Case 2.4/control 6.5 h2Both1.77 (0.57-5.45)H. pylori, smoking, drinking, and education level/matched on age, sex, year and area of enrollment, and follow-up duration9
Khan et al[28]CSJapanSelf reported40-79192Male7.5%0.72 (0.40-1.09)Age, BMI, smoking, drinking8
Female4.6%0.26 (0.08-0.82)
Rapp et al[15]CSAustriaFBS (4.2-5.2 mmol/L vs 7.0 mmol/L)> 19141Male3.9%0.84 (0.38-1.87)Age, smoking, occupation, BMI8
Female3.0%-3
Rousseau et al[56]CCCanadaSelf reported35-702Male1.0 (0.5-1.8)Age, income, education, ethnicity, proxy status, BMI, smoking, beta-carotene, alcohol7
Jee et al[26]CSSouth KoreaFBS (< 90 mg/dL vs≥ 126 mg/dL) or DM medication30-95101Male5.1%1.11 (1.04-1.2)Age, age squared, smoking, alcohol8
Female4.5%1.15 (0.99-1.34)
La Vecchia et al[25]CCItalySelf reported ≤ 75Not mentionedMale0.6 (0.4-1.0)Age6
Female0.7 (0.4-1.2)
O'Mara et al[21]CCUSA (only white)Self reported30-891Male0.91 (0.28-2.27)2Age4 (3)5
Female1.57 (0.48-3.94)
Table 2 Preexisting diabetes and risk of gastric cancer by subgroup meta-analysis using random effect model
Studies (n)RR (95%CI)I2% (95%CI)
Overall271.19 (1.08-1.31)70.7 (56.8-80.2)
Countries
East Asian countries1101.19 (1.02-1.38)60.1 (20.0-80.1)
Western countries2171.18 (1.03-1.36)75.6 (61.0-84.8)
Study type
Cohort study181.20 (1.08-1.34)75.5 (61.2-84.5)
Case control study91.12 (0.87-1.45)57.9 (11.8-79.9)
Sex
Male121.10 (0.97-1.24)74.9 (55.7-85.8)
Female91.24 (1.01-1.52)58.9 (14.1-80.3)
DM criteria
Registration81.21 (1.02-1.44)83.0 (67.8-91.0)
Measured351.15 (1.01-1.32)35.5 (0.0-75.8)
Self report141.13 (0.93-1.39)65.2 (38.6-80.3)
Interval4
One and more years151.15 (1.02-1.31)67.5 (44.3-81.0)
Quality (NOS)
High quality (8 and more)171.17 (1.05-1.31)73.4 (57.0-83.6)
Low quality (7 and less)101.20 (0.97-1.49)61.2 (22.6-80.5)
Adjustment for risk factor
Smoking5121.17 (1.01-1.34)52.6 (8.7-75.4)
H. pylori522.35 (1.24-4.46)0.0 (UC)
Cancer site
Cardia cancer21.39 (0.72-2.69)82.3 (UC)
Noncardia cancer21.19 (0.80-1.77)59.6 (UC)