Cancer Res Treat.  2025 Apr;57(2):339-349. 10.4143/crt.2024.586.

Weight Change after Cancer Diagnosis and Risk of Diabetes Mellitus: A Population-Based Nationwide Study

Affiliations
  • 1Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 2Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 3Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
  • 4Samsung C&T Medical Clinic, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 5Department of Family Medicine/Obesity and Metabolic Health Center, Kangdong Sacred Heart Hospital, Hallym University, Seoul, Korea
  • 6Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 7Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 8Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 9Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea

Abstract

Purpose
Cancer survivors are at increased risk of diabetes mellitus (DM). Additionally, the prevalence of obesity, which is also a risk factor for DM, is increasing in cancer survivors. We investigated the associations between weight change after cancer diagnosis and DM risk.
Materials and Methods
This retrospective cohort study used data from the Korean National Health Insurance Service. Participants who were newly diagnosed with cancer from 2010 to 2016 and received national health screening before and after diagnosis were included and followed until 2019. Weight change status after cancer diagnosis was categorized into four groups: sustained normal weight, obese to normal weight, normal weight to obese, or sustained obese. Cox proportional hazard analyses were performed to examine associations between weight change and DM.
Results
The study population comprised 264,250 cancer survivors. DM risk was highest in sustained obese (adjusted hazard ratios [aHR], 2.17; 95% confidence interval [CI], 2.08 to 2.26), followed by normal weight to obese (aHR, 1.66; 95% CI, 1.54 to 1.79), obese to normal weight (aHR, 1.29; 95% CI, 1.21 to 1.39), and then sustained normal weight group (reference). In subgroup analyses according to cancer type, most cancers showed the highest risks in sustained obese group.
Conclusion
Obesity at any time point was related to increased DM risk, presenting the highest risk in cancer survivors with sustained obesity. Survivors who changed from obese to normal weight had lower risk than survivors with sustained obesity. Survivors who changed from normal weight to obese showed increased risk compared to those who sustained normal weight. Our finding supports the significance of weight management among cancer survivors.

Keyword

Body weight changes; Weight loss; Weight gain; Obesity; Diabetes mellitus; Neoplasms; Cancer survivors

Figure

  • Fig. 1. Flow chart of study population selection.


Reference

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