Comprehensive risk profiles of family history and lifestyle and metabolic risk factors in relation to diabetes: A prospective cohort study

Family history of diabetes mellitus and risk of colorectal cancer: A nationwide cohort study

AIMS

Studies have shown the association between personal history of diabetes mellitus (DM type 1/2) and risk of colorectal cancer (CRC). This study aims to find the association between the family history of diabetes and CRC risk.

METHODS

This large nationwide cohort study leveraged data from several Swedish nationwide registers (follow-up: 1964-2018) to compare the risk using standardized incidence ratio (SIR).

RESULTS

11,784,567 individuals (668,348 with DM) were included and followed for up to 54 years (median = 28 years). Those with a personal history of DM had a 1.4-fold increased risk of CRC compared to those without DM (95 % CI: 1.39-1.45). However, the addition of a family history of DM in 1 FDR or ≥ 2 FDRs did not significantly alter the increased risk of early-onset or late-onset CRC.

CONCLUSION

Leveraging one of the world's largest family-disease datasets, our cohort study confirmed that personal history of diabetes is associated with an increased risk of colorectal cancer, but we did not find an association between a family history of diabetes and risk of colorectal cancer.

X-box binding protein 1: A new metabolic mediator and drug target of metformin?

Accumulating evidence has demonstrated that metformin improved hypertriglyceridemia. The present study aim to investigate the molecular mechanism by which metformin improves hypertriglyceridemia via regulation of diacylglycerol O-acyltransferase 2 (DGAT2) and X-box binding protein 1 (XBP1) in the liver and whether AMP-activated protein kinase (AMPK) is involved. Mice were fed a high-fat diet (HFD) or high-fat diet with metformin for 5 weeks to evaluate the effect of metformin on triglyceride (TG) levels and expression of DGAT2 and XBP1 in the liver. In vitro HepG2 cells or XBP1 knockout AML12 hepatocytes were stimulated with metformin, palmitic acid or small interfering RNA inducing XBP1 knockdown, or dominant-negative mutant AMPK plasmid. Metformin treatment reduced hepatic TG levels in the liver of HFD-fed mice. Expression of nuclear and cytoplasmic XBP1 protein and its downstream target gene DGAT2 decreased in the liver of HFD-fed mice and HepG2 cells after metformin treatment. AMPK inactivation or overexpression of XBP1 attenuates this effect. Our preliminary results demonstrate that metformin activates AMPK to reduce TG synthesis by inhibiting the XBP1-mediated DGAT2 pathway, at least in part, suggesting that XBP1 is a new metabolic mediator for metformin treatment of hypertriglyceridemia and associated metabolic disease.