Objective: To analyze the clinical characteristics of patients with pancreatic cancer (PC) and diabetes and to explore the impact of diabetes duration, weight loss, and hypoglycemic drugs on the tumor biological behavior of PC.
Methods: This is a retrospective study on patients with PC and diabetes. Subjects were grouped according to the onset age of PC, distant metastasis, duration of diabetes, degree of weight loss (∆Wt), and type of hypoglycemic drugs. Logistic regression analysis was used to evaluate the association between diabetes duration, weight loss, hypoglycemic drugs, and early-onset PC, distant metastasis.
Results: Compared with late-onset PC, patients with early-onset PC had a higher proportion of new-onset DM (35 [79.5%] vs. 217 [46.9%], p < 0.001), smoker, drinker, and more obvious weight loss (8.5 [3.8, 15] kg vs. 5 [0, 10] kg, p < 0.001). Patients with remote metastasis had an earlier diagnosis age, heavier weight loss, lower body mass index, and were more likely to be smokers but had cancer less likely to be localized in the head of pancreas. Regression analysis showed that new-onset diabetes and weight loss were independently correlated to early-onset PC: odds ratio (OR) = 3.38 (95% CI 1.36-8.4, p = 0.09; OR = 1.56 (95% CI 1.16-2.1), p = 0.003, respectively. In contrast, long-term diabetes, and heavy weight loss were independently associated with remote metastasis: OR = 3.38 (95% CI 1.36-8.4, p = 0.09; OR = 1.56 (95% CI 1.16-2.1), p = 0.003, respectively.
Conclusion: New-onset diabetes and weight loss were common presentation and risk factors of early-onset PC, which required more attention. Long-term diabetes and heavy weight loss were risk factors contributing to distant metastases, indicating potential risk factors contributing to the adverse prognosis of patients with PC.
目的: 分析胰腺癌(PC)合并糖尿病患者的临床特点, 探讨糖尿病病程、体重减轻及降糖药物对PC肿瘤生物学行为的影响。 方法: 对PC合并糖尿病患者进行回顾性研究。受试者根据PC的发病年龄、远处转移、糖尿病病程、体重减轻程度(∆Wt)和降糖药物的类型进行分组。采用Logistic回归分析评估糖尿病病程、体重减轻、降糖药物与早发性PC、远处转移之间的关系。 结果: 与晚发PC相比, 早发PC患者新发DM比例更高(35[79.5%]vs 217[46.9%], p<0.001), 吸烟、饮酒和体重减轻更明显(8.5[3.8, 15]kg vs 5[0, 10]kg, p<0.001)。远处转移的患者诊断年龄较早, 体重减轻较大, 体重指数较低, 且更有可能是吸烟者, 但癌症不太可能发生在胰头。回归分析显示, 新发糖尿病和体重减轻与早发PC独立相关:分别为优势比(OR)=3.38(95%置信区间(CI) 1.36~8.4, P=0.09), OR=1.56(95%CI 1.16~2.1), P=0.003。相反, 长期糖尿病和严重的体重减轻与远处转移独立相关:分别为OR=3.38(95%CI 1.36-8.4, p=0.09, OR=1.56(95%CI 1.16-2.1), p=0.003)。 结论: 新发糖尿病和体重减轻是早发性PC的常见表现和危险因素, 应引起更多重视。长期糖尿病和体重减轻是导致远处转移的危险因素, 这表明潜在的危险因素导致了PC患者的不良预后。.
Keywords: anti-diabetic drugs; diabetes mellitus; pancreatic cancer; weight loss; 减肥; 糖尿病; 胰腺癌; 降糖药物.
© 2022 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.