Influence of metabolic syndrome and its components on the prognosis of patients with pancreatic cancer

CHEN Huan; LI Ting; WANG ZiJie; WANG ZhongQiong; LUO Gang; DENG MingMing

doi:10.3969/j.issn.1001-5256.2020.12.029

Volume 36 Issue 12

Dec. 2020

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Influence of metabolic syndrome and its components on the prognosis of patients with pancreatic cancer

DOI: 10.3969/j.issn.1001-5256.2020.12.029

Department of Gastroenterology,The Affiliated Hospital of Southwest Medical University

Research funding:

Received Date: 2020-06-01
Published Date: 2020-12-20

Abstract

Abstract

Objective To investigate the association of metabolic syndrome( MS) and its components with the overall survival of pancreatic cancer( PC) patients who do not receive antitumor therapy. Methods A retrospective analysis was performed for the data of patients who were diagnosed with PC in The Affiliated Hospital of Southwest Medical University from August 2013 to November 2018. Related data were collected,including age,sex,body weight,body height,body mass index( BMI),smoking,drinking,medical history of chronic pancreatitis,medical history of biliary tract diseases and gastritis,medical history of chronic hepatitis B/C,medical history of other tumors,presence or absence of PC in first-grade relatives,blood glucose,blood pressure,high-density lipoprotein cholesterol( HDL-C),triglyceride( TG),MS,and TNM stage. The log-rank test was used for comparison of survival curves between groups,and the univariate and multivariate Cox regression analyses were used to investigate the influencing factors for survival. Results A total 269 PC patients were enrolled in this study,with an average survival time of 3 months. The survival analysis showed no significant difference in survival time between the patients with MS and those without MS( P = 0. 754). There was no significant difference in median survival time between the patients with hypertension,high TG,high HDL-C,or abnormal BMI and those without such abnormality( all P > 0. 05). There was a significant difference in median survival time between the patients with hyperglycemia and those without hyperglycemia( hazard ratio [HR]= 1. 322,95%confidence interval [CI]: 0. 985-1. 775,P = 0. 028),and the multivariate Cox regression analysis achieved consistent results( HR =1. 481,95% CI: 1. 043-2. 104,P = 0. 028). The analysis of the influencing factors for survival time in patients with stage Ⅳ PC showed that the patients with hyperglycemia had a significant reduction in median survival time( HR = 1. 524,95% CI: 1. 046-2. 218,P =0. 004). Conclusion MS is not an influencing factor for the survival of PC patients,but hyperglycemia is an independent risk factor for poor prognosis in PC patients,especially in those with advanced PC.
- pancreatic neoplasms,
- metabolic syndrome X,
- hyperglycemia,
- prognosis

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[1] YADAV D,LOWENFELS AB. The epidemiology of pancreatitis and pancreatic cancer[J]. Gastroenterology,2013,144(6):1252-1261.

[2] National Cancer Institute(NCI). Common cancer types[EB/OL]. https://www. cancer. gov/types/common-cancers.

[3] SIEGEL RL,MILLER KD,JEMAL A. Cancer statistics,2019[J]. CA Cancer J Clin,2019,69(1):7-34.

[4] LYU Y,WEI RZ,WU HS. Early diagnosis for pancreatic cancer[J]. J Clinical Emergency,2018,19(3):149-151.(in Chinese)吕翼，魏若征，吴河水．胰腺癌的早期诊断[J]．临床急诊杂志，2018,19(3):149-151.

[5] WANG DS,WANG ZQ,ZHANG L,et al. Are risk factors associated with outcomes in pancreatic cancer?[J]. PLo S One,2012,7(7):e41984.

[6] JIANG QL,WANG CF,TIAN YT,et al. Body mass index does not affect the survival of pancreatic cancer patients[J]. World J Gastroenterol,2017,23(34):6287-6293.

[7] ECKEL RH,GRUNDY SM,ZIMMET PZ. The metabolic syndrome[J]. Lancet,2005,365(9468):1415-1428.

[8] GUO HJ,NIAN X,LIANG YF,et al. The prevalence and risk factors of metabolic syndrome in Chinese population based on the multi center cross-sectional survey[J]. Chin J Dis Control Prev,2019,23(7):796-801.(in Chinese)郭海健，念馨，梁友芳，等．基于多中心横断面调查的中国人群代谢综合征的流行情况及危险因素[J]．中华疾病控制杂志，2019,23(7):796-801.

[9] YUNUSOVA NV,KONDAKOVA IV,KOLOMIETS LA,et al. The role of metabolic syndrome variant in the malignant tumors progression[J]. Diabetes Metab Syndr,2018,12(5):807-812.

[10] HAMMARSTEN J,DAMBER JE,HAGHSHENO MA,et al. A stage-dependent link between metabolic syndrome components and incident prostate cancer[J]. Nat Rev Urol,2018,15(5):321-333.

[11] CROFT B,REED M,PATRICK C,et al. Diabetes,obesity,and the metabolic syndrome as prognostic factors in stages I toⅢcolorectal cancer patients[J]. J Gastrointest Cancer,2019,50(2):221-229.

[12] ROSATO V,TAVANI A,BOSETTI C,et al. Metabolic syndrome and pancreatic cancer risk:A case-control study in Italy and meta-analysis[J]. Metabolism,2011,60(10):1372-1378.

[13] YAMAZAKI H,TAUCHI S,KIMACHI M,et al. Association between pancreatic fat and incidence of metabolic syndrome:A5-year Japanese cohort study[J]. J Gastroenterol Hepatol,2018,33(12):2048-2054.

[14] PARK SK,OH CM,KIM MH,et al. Metabolic syndrome,metabolic components,and their relation to the risk of pancreatic cancer[J]. Cancer,2020,126(9):1979-1986.

[15] Diabetes Society of Chinese Medical Association. Chinese guidelines for the prevention and treatment of type 2 diabetes mellitus(2017 Edition)[J]. Chin J Diabetes,2018,10(1):4-67.(in Chinese)中华医学会糖尿病学分会．中国2型糖尿病防治指南(2017年版)[J]．中华糖尿病杂志，2018,10(1):4-67.

[16] CHEN CM,KONG LZ. Guidelines for prevention and control of overweight and obesity in Chinese adults[M]. Beijing:People’s Medical Publishing House,2016:10-30.(in Chinese)陈春明，孔灵芝．中国成人超重和肥胖症预防控制指南[M]．北京:人民卫生出版社，2016:10-30.

[17] Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Chinese guidelines on prevention and treatment of dyslipidemia in adults(no abstract)[J]. Chin J Cardiol,2007,35(5):390-419.(in Chinese)中国成人血脂异常防治委指南制定联合委员会．中国成人血脂异常防治指南[J]．中华心血管病杂志，2007,35(5):390-419.

[18] COURT CM,HINES OJ. The New American Joint Committee on Cancer TNM Staging System for pancreatic cancer-balancing usefulness with prognostication[J]. JAMA Surg,2018,153(12):e183629.

[19] CARPELAN-HOLMSTRM M,NORDLING S,PUKKALA E,et al. Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study re-evaluating the data of the Finnish Cancer Registry[J]. Gut,2005,54(3):385-387.

[20] van ROESSEL S,KASUMOVA GG,VERHEIJ J. International Validation of the Eighth Edition of the American Joint Committee on Cancer(AJCC)TNM Staging System in patients with resected pancreatic cancer[J]. Jama Surg,2018,153(12):e183617.

[21] LI Y,TANG CG,ZHAO Y,et al. Outcomes and prognostic factors of patients with stage IB andⅡA pancreatic cancer according to the 8th edition American Joint Committee on Cancer criteria[J]. World J Gastroenterol,2017,23(15):2757-2762.

[22] BORENA W,EDLINGER M,BJRGE T,et al. A prospective study on metabolic risk factors and gallbladder cancer in the metabolic syndrome and cancer(Me-Can)collaborative study[J]. PLo S One,2014,9(2):e89368.

[23] BARKIN JA,WESTERMANN A,HOOS W,et al. Frequency of appropriate use of pancreatic enzyme replacement therapy and symptomatic response in pancreatic cancer patients[J].Pancreas,2019,48(6):780-786.

[24] MCGUIRE S. World Cancer Report 2014. Geneva,Switzerland:World Health Organization,International agency for research on cancer,WHO Press,2015[J]. Adv Nutr,2016,7(2):418-419.

[25] ZHOU XH,QIAO Q,ZETHELIUS B,et al. Diabetes,prediabetes and cancer mortality[J]. Diabetologia,2010,53(9):1867-1876.

[26] CUI Y,ANDERSEN DK. Diabetes and pancreatic cancer[J].Endocr Relat Cancer,2012,19(5):F9-F26.

[27] HAN L,MA Q,LI J,et al. High glucose promotes pancreatic cancer cell proliferation via the induction of EGF expression and transactivation of EGFR[J]. PLo S One,2011,6(11):e27074.

[28] LI XC,TU JK,GONG JP. Association between oxidative stress and pancreatic cancer[J]. J Clin Hepatol,2017,33(10):2035-2038.(in Chinese)李小成，涂经楷，龚建平．氧化应激与胰腺癌的关系[J]．临床肝胆病杂志，2017,33(10):2035-2038.

[29] ANDERSEN DK,KORC M,PETERSEN GM,et al. Diabetes,pancreatogenic diabetes,and pancreatic cancer[J]. Diabetes,2017,66(5):1103-1110.

[30] RITCHIE SA,AKITA H,TAKEMASA I,et al. Metabolic system alterations in pancreatic cancer patient serum:Potential for early detection[J]. BMC Cancer,2013,13:416.

[31] KHAN J,SOLAKIVI T,SEPPNEN H,et al. Serum lipid and fatty acid profiles are highly changed in patients with alcohol induced acute pancreatitis[J]. Pancreatology,2012,12(1):44-48.

[32] BLOCH-DAMTI A,BASHAN N. Proposed mechanisms for the induction of insulin resistance by oxidative stress[J]. Antioxid Redox Signal,2005,7(11-12):1553-1567.

[33] REGNSTR MJ,NILSSON J,TORNVALL P,et al. Susceptibility to low-density lipoprotein oxidation and coronary atherosclerosis in man[J]. Lancet,1992,339(8803):1183-1186.

[34] van HEMELRIJCK M,WALLDIUS G,JUNGNER I,et al. Low levels of apolipoprotein A-I and HDL are associated with risk of prostate cancer in the Swedish AMORIS study[J]. Cancer Causes Control,2011,22(7):1011-1019.

[35] SHI YQ,YANG J,DU P,et al. Effect of body mass index on overall survival of pancreatic cancer:A Meta-analysis[J].Medicine(Baltimore),2016,95(14):e3305.

[36] GHASEMI A,SAEIDI J,AZIMI-NEJAD M,et al. Leptin-induced signaling pathways in cancer cell migration and invasion[J]. Cell Oncol(Dordr),2019,42(3):243-260.

[37] DALAL S,HUI D,BIDAUT L,et al. Relationships among body mass index,longitudinal body composition alterations,and survival in patients with locally advanced pancreatic cancer receiving chemoradiation:A pilot study[J]. J Pain Symptom Manage,2012,44(2):181-191.

[38] UZUNLULU M,TELCI CAKLILI O,OGUZ A. Association between metabolic syndrome and cancer[J]. Ann Nutr Metab,2016,68(3):173-179.

[39] GONG Y,ZHANG L,ZHANG A,et al. GATA4 inhibits cell differentiation and proliferation in pancreatic cancer[J]. PLo S One,2018,13(8):e0202449.

[40] XIAO F,GUO XY,WANG G,et al. Research status and development of digestive system microecology and pancreatic cancer[J]. Chin J Dig Surg,2019,18(10):1001-1004.(in Chinese)肖繁，郭笑宇，王刚，等．消化系统微生态与胰腺癌的研究现状和发展[J]．中华消化外科杂志，2019,18(10):1001-1004.

[41] HENRIKSON NB,AIELLO BOWLES EJ,BLASI PR,et al.Screening for pancreatic cancer:Updated evidence report and systematic review for the US preventive services task force[J]. JAMA,2019,322(5):445-454.

[42] CAMARA SN,YIN T,YANG M,et al. High risk factors of pancreatic carcinoma[J]. J Huazhong Univ Sci Technolog Med Sci,2016,36(3):295-304.

[43] PRINCIPE DR,RANA A. Updated risk factors to inform early pancreatic cancer screening and identify high risk patients[J]. Cancer Lett,2020,485:56-65.

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Influence of metabolic syndrome and its components on the prognosis of patients with pancreatic cancer

DOI: 10.3969/j.issn.1001-5256.2020.12.029

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