Metabolic dysfunction-associated profiles and subsequent site-specific risk of obesity-related cancers among Chinese patients with diabetes: a retrospective cohort study

Sep 21, 2026

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A retrospective cohort study compared metabolic dysfunction-associated profiles across diabetes patients who later developed different obesity-related, site-specific cancers versus those remaining cancer-free during follow-up. Public outpatient records in Hong Kong included 391,921 participants without prior malignancy. Site-specific outcomes included colorectal, liver, pancreatic, bladder, kidney, and stomach cancers, analyzed using Cox proportional hazards models. Waist-to-hip ratio, glycated haemoglobin, lipid fractions, and liver cirrhosis showed differential cancer associations, while hypertension showed no significant links.

LanguageEnglish

CategoryResearch & Report

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Pages12

Reading Time30 min

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Abstract

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Open access Original research To cite: Yau STY, Leung E, Wong MCS, et al. Metabolic dysfunction-associated profilesand subsequent site-specific risk of obesity-related cancers among Chinese patients with diabetes: a retrospective cohort study. BMJ Open 2024;14:e082414 . doi:10 . 1136/ bmjopen-2023-082414 ► Prepublication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[bmjopen-2023-082414](bmjopen-2023-082414)) . STYY and EL are joint first authors. Received 22 November 2023 Accepted 13 March 2024 © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China Correspondence to Dr Eman Leung; [yeemanleung@cuhk.edu.hk](yeemanleung@cuhk.edu.hk) Metabolic dysfunction-associated profiles and subsequent site-specific risk of obesity-related cancers among Chinese patients with diabetes: a retrospective cohort study Sarah Tsz Yui Yau, Eman Leung , Martin Chi Sang Wong , Chi Tim Hung, Ka Chun Chong , Albert Lee , Eng Kiong Yeoh ABSTRACT Objectives To compare metabolic dysfunction-associated profiles between patients with diabetes who developed different obesity-related site-specific cancers and those who remained free of cancer during follow-up. Design Retrospective cohort study. Setting Public general outpatient clinics in Hong Kong. Participants Patients with diabetes without a history of malignancy (n=391 921) . Primary outcome measures The outcomes of interest were diagnosis of site-specific cancers (colon and rectum, liver, pancreas, bladder, kidney and stomach) during follow-up. Cox proportional hazards regression was applied to assess the associations between metabolic dysfunction and other clinical factors with each sitespecific cancer. Results Each 0.1 increase in waist-to-hip ratio was associated with an 11%–35% elevated risk of colorectal, bladder and liver cancers. Each 1% increase in glycated haemoglobin was linked to a 4%–9% higher risk of liver and pancreatic cancers. While low-density lipoprotein cholesterol and triglycerides were inversely associated with the risk of liver and pancreatic cancers, high-density lipoprotein cholesterol was negatively associated with pancreatic, gastric and kidney cancers, but positively associated with liver cancer. Furthermore, liver cirrhosis was linked to a 56% increased risk of pancreatic cancer. No significant association between hypertension and cancer risk was found. Conclusions Metabolic dysfunction-associated profiles contribute to different obesity-related cancer outcomes differentially among patients with diabetes. This study may provide evidence to help identify cancer prevention targets during routine diabetes care. INTRODUCTION Type 2 diabetes mellitus (DM) is a metabolic disorder characterised by chronic hyperglycaemia due to progressive loss of pancreatic β-cell function in insulin secretion on the background of insulin resistance and metabolic dysfunction.1 Previous meta-analyses STRENGTHS AND LIMITATIONS OF THIS STUDY ⇒ This study used territory-wide electronic health records to examine site-specific cancer risk among a large diabetes cohort (n=391 921) . ⇒ This single study systematically compared the metabolic dysfunction-associated profiles between patients with diabetes who developed six different site-specific cancers and those who remained free of cancer during follow-up. ⇒ Generalisability of the findings could be limited to adult Chinese diabetes population. have shown that patients with diabetes are at higher risk of developing cancer at several sites, including the liver,2 pancreas,3 colon and rectum,4 bladder5 and possibly kidney.6 With the exception of bladder canc

FAQs

What was the study’s main objective?

To compare metabolic dysfunction-associated profiles between diabetes patients who developed different obesity-related, site-specific cancers and those who remained free of cancer during follow-up.

What data source and population were used?

Public general outpatient clinics in Hong Kong were used, including 391,921 diabetes patients without a history of malignancy.

Which factors were associated with higher or lower cancer risks?

Higher waist-to-hip ratio and increased glycated haemoglobin were linked to elevated risks for specific cancers; lipid measures showed inverse or directionally mixed associations depending on cancer site. Liver cirrhosis increased pancreatic cancer risk, while hypertension showed no significant association.

Sep 21, 2026

Uploaded by Hazel