Does diabetes decrease the risk of glioma? A systematic review and meta-analysis of observational studies

Ann Epidemiol. 2019 Feb:30:22-29.e3. doi: 10.1016/j.annepidem.2018.11.010. Epub 2018 Nov 26.

Abstract

Purpose: Increasing epidemiologic evidence suggests that diabetes mellitus (DM) may be associated with a decreased risk of glioma. This systematic review assessed whether DM was associated with glioma risk.

Methods: Electronic searches were performed in PubMed, Web of Science, EMBASE, and Cochrane Library databases up to August 30, 2018. A random-effects model was performed to calculate summary effect size with corresponding 95% confidence intervals (CIs).

Results: In total, 10 studies (eight case-control studies and two cohort studies) matched the inclusion criteria. Meta-analyses of case-control studies showed that DM decreased the risk of glioma by 23% (odds ratio: 0.77, 95% CI: 0.61-0.96; P = .02, I2 = 82.0%). However, no such effect was observed in cohort studies (relative risk: 0.71, 95% CI: 0.10-4.80; P = .72, I2 = 61.6%). In the subgroup analyses, DM was associated with a decreased risk of glioma in Caucasians but not in Asians; the inverse association was slightly higher in males than in females.

Conclusions: Our results indicate that DM decreases the risk of glioma, but the inverse association may vary in subgroups. The present conclusions should be confirmed with further studies.

Keywords: Diabetes mellitus; Glioblastoma; Glioma; Meta-analysis; Risk.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Brain Neoplasms / epidemiology
  • Brain Neoplasms / etiology*
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Female
  • Glioma / epidemiology
  • Glioma / etiology*
  • Humans
  • Male
  • Observational Studies as Topic*
  • Risk Factors