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Background <p>Cancer cells increase their uptake and use of glucose to facilitate processes such as proliferation and metastasis development. It may therefore be speculated that the availability of glucose in the blood may influence cancer progression and impact clinical outcomes. This study exploratively investigated if blood glucose levels (HbA1c) were associated with overall survival, in an unselected population representing a real-world group of patients diagnosed with cancer.</p> Methods <p>Between 2012 and 2017 a total of 296 patients diagnosed with lung (<i>n</i> = 99), colon (<i>n</i> = 98) and ovarian (<i>n</i> = 99) cancer were included. The patients were included from three clinical cohorts (the LUCAS cohort study (lung cancer), the REBECCA cohort study (colon cancer) and the Pelvic Mass/GOVEC study (ovarian cancer)) based on a few inclusion and exclusion criteria. HbA1c was measured using a blood sample taken during the course of treatment. Survival analysis was performed using the Kaplan-Meier method and multivariate Cox regression.</p> Results <p>We observed that lower levels of blood glucose (HbA1c) were significantly associated with improved overall survival across the three different cancer types. In combined univariate analysis including all 296 patients, an HbA1c value &lt; 40 mmol/mol (5.8%) was associated with a 5-year survival of 55.1%, whereas an HbA1c value ≥ 40 mmol/mol (5.8%) was associated with a 5-year survival of 27.0% (P-value &lt; 0.0001). Furthermore, an HbA1c value within the interval (-inf, 30] mmol/mol ((-inf, 4.9%]) was associated with a 5-year survival of 66.7%, with increasing HbA1c intervals gradually correlating with decreased survival (P-value &lt; 0.0001). Multivariate analysis maintained an HbA1c value &lt; 40 mmol/mol (5.8%) as an independent factor with an estimated hazard ratio of 0.64 (95% CI 0.45, 0.91 P-value = 0.013).</p> Conclusions <p>These results raise the question whether HbA1c could serve as an important prognostic factor across multiple types of cancer, and whether therapeutically controlling the blood glucose level might potentially be beneficial. However, further studies are needed before definitive conclusions can be made.</p>

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Lower blood glucose levels (HbA1c) within the non-diabetic range are associated with improved survival in patients diagnosed with lung, colon and ovarian cancer: an explorative study

  • 期刊论文

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  • 发表日期：

    2026年7月11日

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  • Oliver Abrahamsen,
  • Jakob Hagen Vasehus Schou,
  • Jakob Sidenius Johansen,
  • Mie Bejstrup Jensen,
  • Jakob Lykke,
  • Claus Høgdall,
  • Esben Budtz-Jørgensen,
  • Estrid Høgdall

摘要

Background

Cancer cells increase their uptake and use of glucose to facilitate processes such as proliferation and metastasis development. It may therefore be speculated that the availability of glucose in the blood may influence cancer progression and impact clinical outcomes. This study exploratively investigated if blood glucose levels (HbA1c) were associated with overall survival, in an unselected population representing a real-world group of patients diagnosed with cancer.

Methods

Between 2012 and 2017 a total of 296 patients diagnosed with lung (n = 99), colon (n = 98) and ovarian (n = 99) cancer were included. The patients were included from three clinical cohorts (the LUCAS cohort study (lung cancer), the REBECCA cohort study (colon cancer) and the Pelvic Mass/GOVEC study (ovarian cancer)) based on a few inclusion and exclusion criteria. HbA1c was measured using a blood sample taken during the course of treatment. Survival analysis was performed using the Kaplan-Meier method and multivariate Cox regression.

Results

We observed that lower levels of blood glucose (HbA1c) were significantly associated with improved overall survival across the three different cancer types. In combined univariate analysis including all 296 patients, an HbA1c value < 40 mmol/mol (5.8%) was associated with a 5-year survival of 55.1%, whereas an HbA1c value ≥ 40 mmol/mol (5.8%) was associated with a 5-year survival of 27.0% (P-value < 0.0001). Furthermore, an HbA1c value within the interval (-inf, 30] mmol/mol ((-inf, 4.9%]) was associated with a 5-year survival of 66.7%, with increasing HbA1c intervals gradually correlating with decreased survival (P-value < 0.0001). Multivariate analysis maintained an HbA1c value < 40 mmol/mol (5.8%) as an independent factor with an estimated hazard ratio of 0.64 (95% CI 0.45, 0.91 P-value = 0.013).

Conclusions

These results raise the question whether HbA1c could serve as an important prognostic factor across multiple types of cancer, and whether therapeutically controlling the blood glucose level might potentially be beneficial. However, further studies are needed before definitive conclusions can be made.