Dose-response association between alcohol consumption and kidney cancer risk according to glycemic status

초록

Background Although previous studies have suggested that light-to-moderate alcohol consumption enhances insulin sensitivity and decreases kidney cancer risk, it is unknown whether the effect of alcohol consumption on kidney cancer risk differs according to diabetes status. We investigated the dose-response association between alcohol consumption and kidney cancer risk in individuals with and without diabetes. Methods This nationwide cohort study enrolled 9,492,331 adults without cancer who underwent the national health screening in 2009 and were followed up until December 31, 2018. Multivariable Cox proportional hazards regression models were used to estimate the risk after adjusting for potential confounders. Results During the 78.1 million person-years of follow-up, 12,381 patients were newly diagnosed with kidney cancer. In individuals without diabetes, light-to-moderate alcohol consumption (< 30 g of alcohol per day) was associated with a decreased risk of kidney cancer (adjusted hazard ratio [aHR], 0.94; 95% CI, 0.90–0.99), but not heavy alcohol consumption (aHR, 1.02; 95% CI, 0.95–1.10). In individuals with diabetes, light-to-moderate and heavy alcohol consumption was associated with an increased risk of kidney cancer compared to non-drinkers without diabetes (aHR, 95% CI: 1.10, 1.02–1.20 and 1.22, 1.07–1.39, respectively). Conclusions Light-to-moderate alcohol consumption, but not heavy alcohol consumption, was associated with a modestly decreased risk of kidney cancer only in individuals without diabetes. Individuals with diabetes who consumed alcohol had an increased risk of kidney cancer. The potential carcinogenic effects of alcohol consumption on kidney cancer should not be overlooked. Individualized and refined education on the association between alcohol consumption and kidney cancer risk should be provided.