Prognostic significance of glucose‐lipid metabolic index in pancreatic cancer patients with diabetes mellitus

作者：Hailiang Wang, Shiye Ruan, Zelong Wu, Qian Yan, Yubin Chen, Jinwei Cui, Zhongyan Zhang, Shanzhou� Huang, Baohua Hou, Chuanzhao Zhang · 发表于：Cancer Medicine · 年份：2024 · DOI：10.1002/cam4.7108 · 被引用次数：25 · 研究领域：Cancer, Lipids, and Metabolism、Pancreatic and Hepatic Oncology Research、Inflammatory Biomarkers in Disease Prognosis

BACKGROUND: The incidence of pancreatic cancer (PC) is higher in diabetic patients due to disturbances in glucose and lipid metabolism caused by insulin resistance (IR). However, the effect of diabetes as well as IR on the prognosis of PC patients remains inconclusive. Our study aims to assess the impact of IR on the prognosis of PC patients with diabetes. METHODS: We conducted a retrospective analysis of 172 PC patients with diabetes in our institute from 2015 to 2021. Prognostic assessment was performed using univariate/multifactorial analysis and survival analysis. The predictive efficacy of metabolic indices was compared using receiver operator characteristic (ROC) curve analysis. RESULTS: One hundred twenty-one of 172 patients died during follow-up, with a median follow-up of 477 days and a median overall survival (OS) of 270 days. Survival analysis showed a significant difference in OS by IR related parameters, which were triglyceride-glucose index (TyG), triglyceride-glucose index-body mass index (TyG-BMI), and triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-c). The ROC curve indicated that TyG, TyG-BMI, and TG/HDL-c had prognostic efficacy for PC with diabetes. We next optimized TyG-BMI and obtained a new parameter, namely glucose-lipid metabolism index (GLMI), and the patients were classified into GLMI low group and high group based on the calculated cutoff value. The GLMI high group had higher TyG, TyG-BMI, TyG/HDL-c, BMI, TG, total cholesterol (TC),...