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Maternal pregestational diabetes and risk of acute lymphoblastic leukemia in the offspring: A population-based study in Northern Italy
Institution:1. Environmental, Genetic and Nutritional Epidemiology Research Centre (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287, 41125 Modena, Italy;2. Department of Paediatrics, Sant''Orsola Hospital, University of Bologna, Via Giuseppe Massarenti, 9, 40138 Bologna, Italy;3. Division of Paediatric Oncology-Haematology, Policlinico Hospital, Largo del Pozzo, 71, 41125 Modena, Italy;4. Local Health Authority of Reggio Emilia, Via Giovanni Amendola, 2, 42122 Reggio Emilia, Italy;5. Department of Epidemiology, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, United States;1. Institute of Medical Epidemiology, Biostatistics and Informatics, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Germany;2. Section of Cancer Information, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France;3. Department of Medicine, University of Zimbabwe School of Medicine, Harare, Zimbabwe;4. Department of Pathology, Maputo Central Hospital, Maputo, Mozambique;5. CTSU, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7FL, United Kingdom;6. African Cancer Registry Network, 267 Banbury Road, Oxford OX2 7HT, United Kingdom;1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark;2. Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA;3. Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark;1. Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China;2. Department of Medical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing China;3. State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing 210023, China;4. State Key Laboratory of Bioelectronics, Southeast University, Nanjing, China;1. Department of Surgery, Division of Urology, Center for Integrated Research on Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA;2. Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA;3. Surgery Section, Durham VA Health Care System, Durham, NC, USA;4. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA;5. Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA;6. Institute for Translational Epidemiology, and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA;7. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA;1. Department of Medicine, University of Kentucky, Lexington, KY, United States;2. Department of Neurology, University of Kentucky, Lexington, KY, United States;3. Departments of Neurosurgery, University of Kentucky, Lexington, KY, United States;4. Departments of Pathology, Division of Neuropathology, University of Kentucky, Lexington, KY, United States;5. Markey Cancer Center, University of Kentucky, Lexington, KY, United States;1. East Tallinn Central Hospital, Oncology Center, Ravi St 18, 10138 Tallinn, Estonia;2. National Institute for Health Development, Department of Epidemiology and Biostatistics, Hiiu St 42, 11619 Tallinn, Estonia;3. West Tallinn Central Hospital, Womens’ Clinic, Paldiski St 68, 10617 Tallinn, Estonia;4. Tartu University Hospital, Haematology and Oncology Clinic, L. Puusepa St 1A, 50406 Tartu, Estonia
Abstract:IntroductionThis population-based study aims to evaluate the association between maternal pregestational diabetes and risk of acute lymphoblastic leukemia (ALL) in the offspring.MethodsAll 241,958 children born in three Northern Italy provinces 1998–2010 were followed from birth until first cancer diagnosis (National Childhood Cancer Register), age 15 years, or 31 December 2017. We computed hazard ratio (HR) and 95% CI of ALL in relation to the presence of maternal diabetes through Cox proportional regression models.ResultsWe observed 145 cases of ALL, with a higher incidence in children born to women with pregestational diabetes compared to the others (12.4 vs 4.6). Adjusted hazard ratio of ALL was 2.6 (CI, 0.6–10.5) for maternal diabetes.DiscussionWe estimated higher risks of ALL in the offspring of women with pregestational diabetes. These results are consistent with previous findings and compatible with a role of prenatal glycaemic environment in childhood cancer aetiology.
Keywords:Acute lymphoblastic leukemia  Pregestational diabetes  Childhood cancers  Risk factors
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