Nutritional status and survival of 8247 cancer patients with or without diabetes mellitus-results from a prospective cohort study

被引：15

作者：

Cong, Minghua ^{[1
]}

Zhu, Wenjie ^{[1
]}

Wang, Chang ^{[2
]}

Fu, Zhenming ^{[3
]}

Song, Chunhua ^{[4
]}

Dai, Zhong ^{[5
]}

Yao, Keqing ^{[5
]}

Guo, Zengqing ^{[6
]}

Lin, Yuan ^{[7
]}

She, Yingying ^{[8
]}

Hu, Wen ^{[9
]}

Ba, Yi ^{[10
]}

Li, Suyi ^{[11
]}

Li, Zengning ^{[12
]}

Wang, Kunhua ^{[13
]}

Wu, Jing ^{[14
]}

He, Ying ^{[15
]}

Yang, Jiajun ^{[16
]}

Xie, Conghua ^{[17
]}

Song, Xinxia ^{[18
]}

Chen, Gongyan ^{[19
]}

Ma, Wenjun ^{[20
]}

Luo, Suxia ^{[21
,22
]}

Chen, Zihua ^{[23
]}

Ma, Hu ^{[24
]}

Zhou, Chunling ^{[25
]}

Wang, Wei ^{[26
]}

Luo, Qi ^{[27
]}

Shi, Yongmei ^{[28
]}

Qi, Yumei ^{[29
]}

Jiang, Haiping ^{[30
]}

Guan, Wenxian ^{[31
]}

Chen, Junqiang ^{[32
]}

Chen, Jiaxin ^{[33
]}

Fang, Yu ^{[34
]}

Zhou, Lan ^{[35
]}

Feng, Yongdong ^{[36
]}

Tan, Rongshao ^{[37
]}

Li, Tao ^{[38
]}

Ou, Junwen ^{[39
]}

Zhao, Qingchuan ^{[40
]}

Wu, Jianxiong ^{[41
]}

Deng, Li ^{[2
]}

Lin, Xin ^{[42
]}

Yang, Liuqing ^{[43
]}

Xu, Hongxia ^{[42
]}

Li, Wei ^{[2
]}

Yu, Lei ^{[1
]}

Stu, Hanping ^{[43
]}

机构：

[1] Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Dept Comprehens Oncol, Natl Clin Res Ctr Canc,Canc Hosp, Beijing 100021, Peoples R China

[2] First Hosp Jilin Univ, Canc Ctr, Changchun 130021, Jilin, Peoples R China

[3] Wuhan Univ, Canc Ctr, Renmin Hosp, Wuhan, Peoples R China

[4] Zhengzhou Univ, Coll Publ Hlth, Dept Epidemiol, Zhengzhou, Peoples R China

[5] Huanxing Canc Hosp, Dept Comprehens Oncol, Beijing, Peoples R China

[6] Fujian Med Univ Canc Hosp, Fujian Canc Hosp, Dept Med Oncol, Fuzhou, Fujian, Peoples R China

[7] Guangxi Med Univ, Dept Gastrointestinal Surg, Affiliated Tumor Hosp, Nanning, Peoples R China

[8] SunYat Sen Univ, Dept Surg, Affiliated Hosp 1, Guangzhou, Peoples R China

[9] Sichuan Univ, Dept Clin Nutr, West China Hosp, Chengdu, Peoples R China

[10] Tianjin Med Univ Canc Inst & Hosp, Natl Clin Res Ctr Canc, Dept Gastrointestinal Oncol, Tianjin Key Lab Canc Prevent & Therapy, Tianjin, Peoples R China

[11] Anhui Med Univ, Dept Nutr & Metab Oncol, Affiliated Prov Hosp, Hefei, Peoples R China

[12] Hebei Med Univ, Dept Clin Nutr, Hosp 1, Shijiazhuang, Hebei, Peoples R China

[13] Kunming Med Univ, Inst Gastroenterol, Dept Gastrointestinal Surg, Affiliated Hosp 1, Kunming, Yunnan, Peoples R China

[14] First Peoples Hosp Kashi, Dept Clin Nutr, Kashgar, Xinjiang, Peoples R China

[15] Chongqing Gen Hosp, Dept Clin Nutr, Chongqing, Peoples R China

[16] Huizhou Municipal Cent Hosp, Dept Colorectal & Anal Surg, Huizhou, Peoples R China

[17] Wuhan Univ, Dept Radiat & Med Oncol, Zhongnan Hosp, Wuhan, Peoples R China

[18] Hebei Med Univ, Xingtai Peoples Hosp, Dept Oncol, Xingtai, Peoples R China

[19] Harbin Med Univ, Tumor Hosp, Dept 1, Harbin, Peoples R China

[20] Guangdong Acad Med Sci, Guangdong Gen Hosp, Dept Nutr, Guangzhou, Peoples R China

[21] Zhengzhou Univ, Dept Oncol, Affiliated Canc Hosp, Zhengzhou, Peoples R China

[22] Henan Canc Hosp, Zhengzhou, Peoples R China

[23] Cent South Univ, Xiangya Hosp, Dept Gen Surg, Changsha, Peoples R China

[24] Zunyi Med Univ, Dept Oncol, Affiliated Hosp, Zunyi, Guizhou, Peoples R China

[25] Harbin Med Univ, Affiliated Hosp 4, Harbin, Peoples R China

[26] First Peoples Hosp Foshan, Canc Ctr, Foshan, Peoples R China

[27] Xiamen Univ, Affiliated Hosp 1, Dept Gastrointestinal Tumor Surg, Xiamen, Peoples R China

[28] Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Nutr, Sch Med, Shanghai, Peoples R China

[29] Tianjin Third Cent Hosp, Dept Nutr, Tianjin, Peoples R China

[30] Jinan Univ, Dept Surg, Affiliated Hosp 1, Guangzhou, Peoples R China

[31] Nanjing Univ, Dept Gen Surg, Nanjing Drum Tower Hosp, Med Sch,Affiliated Hosp, Nanjing, Peoples R China

[32] Guangxi Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 1, Nanning, Peoples R China

[33] Peoples Hosp Guangxi Zhuang Autonomous Reg, Dept Radiat & Med Oncol, Nanning, Peoples R China

[34] Peking Univ Canc Hosp & Inst, Dept Clin Nutr, Beijing, Peoples R China

[35] Kunming Med Coll, Tumor Hosp Yunnan Prov, Dept Nutr, Affiliated Hosp 3, Kunming, Yunnan, Peoples R China

[36] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Surg, Wuhan, Peoples R China

[37] Guangzhou Red Cross Hosp, Dept Nutr, Guangzhou, Peoples R China

[38] Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sichuan Canc Ctr, Sch Med,Dept Radiotherapy, Chengdu, Peoples R China

[39] Guangzhou Univ Chinese Med, Clifford Hosp, Dept Clin Nutr, Guangzhou, Peoples R China

[40] Fourth Mil Med Univ, Xijing Hosp, Dept Digest Dis, Xian, Peoples R China

[41] Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Dept Hepatobiliary Surg, Canc Hosp, Beijing, Peoples R China

[42] Third Mil Med Univ, Daping Hosp & Res Inst Surg, Dept Nutr, Chongqing 400042, Peoples R China

[43] Capital Med Univ, Beijing Shijitan Hosp, Clin Coll 9, Dept Gastrointestinal Surg Clin Nutr, 10 Tieyi Rd, Beijing 100038, Peoples R China

来源：

CANCER MEDICINE | 2020年 / 9卷 / 20期

关键词：

cancer; diabetes mellitus; handgrip; malnutrition; nutritional status; RISK; LIFE;

D O I：

10.1002/cam4.3397

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background The number of cancer patients with diabetes mellitus (DM) is steadily rising. Little is known about the nutritional status of this population. This study characterized the nutritional status and survival of cancer patients with diabetes compared with those without diabetes. Methods A total of 8247 cancer patients were prospectively enrolled from 72 hospitals in China and followed until August 2019. A global estimation of the nutritional status was performed for each participant using standardized tools. The outcomes were cancer-specific survival (CSS) and overall survival (OS). Results The incidence of diabetes was 7.6% in the whole population. In comparison with the non-DM group, the DM group had greater body weight, but a similar fat-free mass, a lower handgrip strength and a decreased Karnofsky performance score. A higher proportion of patients with diabetes were overweight/obese as indicated by BMI. The percentage of patients who were at risk of malnutrition (evaluated by PG-SGA) was higher in the DM group (score >= 4, 56.7% vs 52.9%). Patients with DM showed a worse CSS (4-year CSS, 62% vs 73%) and OS (4-year OS 39% vs 52%). Diabetes was associated with an increased risk of both cancer-specific (hazard ratio (HR) = 1.282, 95% confidence interval (CI) 1.070-1.536) and overall (HR = 1.206, 95% CI 1.040-1.399) mortality. Conclusions Cancer patients with diabetes had a larger body mass but lower muscle strength, poorer performance status and higher incidence of malnourishment. Diabetes was associated with compromised survival. Tailored nutritional intervention is necessary for this subpopulation of patients.

引用

页码：7428 / 7439

页数：12

共 18 条

[1] Long-term All-Cause Mortality in Cancer Patients With Preexisting Diabetes Mellitus A Systematic Review and Meta-analysis [J].