Inflammatory Biomarker Linked to Type 2 Diabetes Shows Increased Risk of Liver Cancer
Furthermore, C-reactive protein has greater prognosis for lung cancer, colorectal cancer, and ovarian cancer.
Investigators find that an inflammatory biomarker that is higher for patients with type 2 diabetes is linked to higher risks of liver and bladder cancer. The results suggest that the biomarker can be used for prognosis of liver cancer, according to the authors of a study published in the British Journal of Cancer.1
Furthermore, C-reactive protein has greater prognosis for lung cancer, colorectal cancer, and ovarian cancer. | Image Credit: VadimGuzhva - stock.adobe.com
“YKL-40 is elevated in many cancers, including liver, colorectal, and lung cancers, where it contributes to tumor progression by promoting growth, inflammation, immune evasion, and metastasis,” the investigators said. “Consistent with this, inhibiting YKL-40 has been shown to effectively reduce tumor growth in these cancers.”
The biomarker, YKL-40, is known to be a biomarker for inflammatory diseases and prediction, with concentrations increasing with age. YKL-40, also known as chitinase-3-like protein, has strong associations with pancreatic and liver disease, arthritis, bronchitis, and sepsis, but investigators also debate its role in cardiovascular diseases, neurological diseases, renal diseases, diabetes, and asthma. Furthermore, investigators have been focusing on using the biomarker as a potential therapeutic agent in various inflammatory and neoplastic diseases.2
In the current study, investigators stated that there were no prospective studies that investigated YKL-40 levels in association with type 2 diabetes and risk of cancer. They aimed to address that knowledge gap by assessing the prognostic value and performance of the biomarker.1
Data was gathered from the Danish Centre for Strategic Research in Type 2 Diabetes cohort, which included patients recently diagnosed with type 2 diabetes, according to the study authors. In April 2023, there were 9010 patients with YKL-40 biomarker levels and 9644 with C-reactive protein (CRP) levels. The primary analysis focused on liver, pancreatic, colorectal, bladder, lung, breast, ovarian, and prostate cancer in association with obesity and type 2 diabetes.1
Investigators included 11,346 patients from the cohort between 2010 and 2024, with a median follow-up time of 9 years. During the follow-up time, 362 patients developed obesity-related cancers, including 329 gastrointestinal cancers—56 liver, 46 pancreatic, and 204 colorectal. There were also 42 bladder and 79 lung cancer events. Elevated YKL-40 levels were associated with a longer duration of diabetes, higher body mass index, waist-to-hip ratio, alcohol overconsumption, smoking, higher hemoglobin A1c, and higher CRP.1
The data show the risk of obesity-related and gastrointestinal cancers had higher levels of YKL-40 (measured by percentile categories), which was driven by liver cancer. The hazard ratios (HRs) for the 96% to 100% percentile compared with the 0% to 33% percentile were 2.4 for obesity-related cancers, 2.6 for gastrointestinal cancers, 44.2 for liver cancers, 1.8 for pancreatic cancer, and 0.6 for colorectal cancer. For bladder and lung cancers, the HRs were 4.2 and 1.5. Investigators also found HRs for cancers related to reproductive organs, which included 1.2 for breast cancer, 0.6 for ovarian cancer, and 0.6 for prostate cancer.1
As for the comparison of YKL-40 and CRP, investigators found similar results for the risk estimates related to obesity and gastrointestinal cancers. However, investigators found that YKL-40 had a greater ability for prognosis of liver and bladder cancers compared with CRP, but CRP had a greater prognosis for lung cancer, colorectal cancer, and ovarian cancer. Investigators also reported that, when stratified by covariates, there were no significant differences in risk estimates at a 95% confidence interval.1
“Studying more than 11,000 individuals newly diagnosed with type 2 diabetes, we found that elevated YKL-40 levels were strongly associated with increased risk of liver cancer and, to a lesser extent, bladder cancer, clearly outperforming CRP for these cancers,” the investigators concluded.1 “However, CRP demonstrated superior prognostic ability for lung, colorectal, and ovarian cancers. These findings indicate that YKL-40 and CRP have distinct prognostic roles in different cancer types among individuals with type 2 diabetes.”
READ MORE: Diabetes Resource Center
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