INTRODUCTION Developing colorectal cancer (CRC) poses challenges for patients with type II diabetes mellitus (T2DM). We investigated CRC risk factors in patients with T2DM. METHODS We retrospectively collected data from the National Health Insurance Corporation database, comprising approximately 97% of the Korean population. T2DM and CRC were defined according to International Classification of Disease codes (10th Revision) and claims data. Obesity was defined using body mass index (BMI); abdominal obesity was defined according to waist circumference. Other variables were defined using demographic, anthropometric, and laboratory data. RESULTS Overall, 2,591,149 patients with T2DM were analyzed. During the follow-up period (median, 5.4 years), 24,236 CRC cases were identified. Aging (≥70 years), male sex, smoking, alcohol consumption, hypertension, and insulin and/or sulfonylurea use were significant risk factors for CRC. In males, smoking and alcohol consumption were more likely to lead to CRC, whereas a BMI increase was a more significant risk factor in females. Females with a BMI ≥ 25 kg/m and abdominal obesity were associated with an 18% increased risk of CRC compared with patients with normal weight and normal waist circumference (hazard ratio = 1.184, 95% confidence interval 1.123-1.25), whereas male patients with a BMI ≥ 25 kg/m and abdominal obesity were associated with an 8% increased risk (hazard ratio = 1.087, 95% confidence interval 1.049-1.127). DISCUSSION Patients had CRC risk factors that differed according to sex. Smoking and heavy alcohol consumption were risks of CRC in males. Female patients with a BMI ≥ 25 kg/m and abdominal obesity were at a higher risk of developing CRC than males.

中文翻译：

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根据II型糖尿病患者性别差异的大肠癌风险：一项基于韩国全国人群的队列研究。

引言结直肠癌（CRC）对II型糖尿病（T2DM）患者构成挑战。我们调查了T2DM患者的CRC危险因素。方法我们回顾性地从国民健康保险公司（National Health Insurance Corporation）数据库中收集数据，该数据约占韩国人口的97％。T2DM和CRC是根据国际疾病分类代码（第10版）和索赔数据定义的。肥胖是通过体重指数（BMI）定义的；根据腰围定义腹部肥胖。使用人口统计学，人体测量学和实验室数据定义其他变量。结果总体上分析了2591149例T2DM患者。在随访期间（中位数为5.4年），发现了24,236例CRC病例。年龄（≥70岁），男性，吸烟，饮酒，高血压，使用胰岛素和/或磺脲类药物是CRC的重要危险因素。在男性中，吸烟和饮酒更容易导致CRC，而BMI升高是女性的重要危险因素。与体重正常和腰围正常的患者相比，BMI≥25 kg / m且腹部肥胖的女性患CRC的风险增加18％（危险比= 1.184，95％置信区间1.123-1.25），而男性患者BMI≥25 kg / m且腹部肥胖与8％的风险增加相关（危险比= 1.087，95％置信区间1.049-1.127）。讨论患者的CRC危险因素因性别而异。吸烟和大量饮酒是男性患CRC的风险。