Study identifies risk of cancer in people with type 2 diabetes and obesity

Researchers found that higher levels of interleukin-6 were associated with increased risk of obesity-related cancers in people who have recently been diagnosed with type 2 diabetes.

Scientists have identified that a simple blood test can detect which individuals with type 2 diabetes are more at risk of certain cancers.

Research has revealed that people with type 2 diabetes are at an increased risk of developing obesity-related cancers, such as thyroid, breast, ovarian, kidney and womb cancer.

In addition, individuals with type 2 diabetes are more at risk of developing multiple myeloma and gastrointestinal cancers, such as pancreatic and colorectal cancer, experts have said.

According to the findings, chronic low-grade inflammation, which is prevalent in both obesity and type 2 diabetes, plays a significant role in cancer development in both conditions.

During the study, the team of researchers examined whether the differences in levels of proinflammatory cytokines would help identify individuals with type 2 diabetes who are particularly at risk of or cancers.

Lead author Mathilde Dahlin Bennetsen said: “Understanding which individuals 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.”

More than 6,000 members of the Danish Center for Strategic Research in Diabetes (DD2) cohort were involved in the study. All of the participants had newly diagnosed with type 2 diabetes.

Levels of proinflammatory cytokines interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and high sensitivity C-reactive protein (hsCRP) were measured at the start of the study.

IL-6 and TNF-alpha are released by adipose tissue and they are often found at higher levels in individuals with type 2 diabetes.

The participants were grouped into three categories based on their IL-6 levels: the lowest third (IL6 ≺0.94pg/ml), the middle third (0.94–1.58pg/ml) and the highest third (>1.58pg/ml).

They were then followed for a median of 8.8 years, during which 327 developed an obesity-related cancer. Higher levels of IL-6 at baseline were associated with a higher risk of developing an OR cancer.

When the results were adjusted for age, sex, diabetes duration, alcohol consumption, waist circumference, physical activity, HbA1c (a measure of how well blood sugar is controlled), triglyceride levels, use of lipid-lowering drugs and use of diabetes medication, those in the highest group had a 51 per cent higher risk of developing a cancer compared with those in the lowest group.

TNF-alpha and hsCRP were only weakly associated with OR cancers compared to IL-6. Factoring in smoking status did not change 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 important increase in ability to predict if an individual would go on to develop one of the cancers. In contrast, the inclusion of TNF-alpha or hsCRP did not improve the predictive models.

The authors conclude that higher IL-6 levels are associated with the development of cancers in people who have recently been diagnosed with type 2 diabetes.

In the future, a simple blood test could identify those at higher risk of the cancers, says Mathilde Dahlin Bennetsen.

However, further research is needed to determine if testing would improve early detection and management of these cancers.

Mathilde Dahlin Bennetsen added: “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.”