通过口服葡萄糖耐量试验对女性乳腺癌患者初诊时及化疗期间葡萄糖不耐受状况及比较
On the status and comparison of glucose intolerance in female breast cancer patients at initial diagnosis and during chemotherapy through an oral glucose tolerance test.
作者信息
Lu Lin-jie, Wang Rui-jue, Ran Liang, Gan Lu, Bai Yang, Jin Liang-bin, Yao Zi-xiang, Liu Sheng-chun, Ren Guo-sheng, Wu Kai-nan, Li Hong-yuan, Kong Ling-quan
机构信息
The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
出版信息
PLoS One. 2014 Apr 1;9(4):e93630. doi: 10.1371/journal.pone.0093630. eCollection 2014.
AIMS
This study is to estimate the status and comparison of glucose intolerance in female breast cancer patients at initial diagnosis and during chemotherapy through an oral glucose tolerance test (OGTT), as well as to learn the effect of chemotherapy on the glucose metabolism of breast cancer patients.
METHODS
All the 79 breast cancer patients at initial diagnosis, with the mean age of 53.2 years, and 96 breast cancer patients before the 5th or 6th cycle of chemotherapy, with the mean age of 51.5 years, participated in the study from December 2012 to October 2013. After an overnight fast, participants underwent OGTT test, and fasting and 2-hour glucose levels were measured to identify undiagnosed diabetes and prediabetes (i.e., impaired fasting glucose or impaired glucose tolerance) in them. Previously diagnosed diabetes among the female breast cancer patients was determined on the self-report and the medical record.
RESULTS
The overall incidences of total normal glucose tolerance, prediabetes, diabetes in female breast cancer patients at initial diagnosis and during chemotherapy were 24.1% and 38.5% (p<0.05), 50.6% and 28.1% (p<0.05), and 25.3% and 33.3% (p>0.05), respectively, and the differences of normal glucose tolerance and prediabetes instead of diabetes between the two groups were statistically significant. About 84% of the total diabetes and prediabetes in the female breast cancer patients at initial diagnosis and 79.7% of those during chemotherapy need to be diagnosed with OGTT.
CONCLUSIONS
Breast cancer patients have high incidences of diabetes and prediabetes. After chemotherapy even with steroids, some breast cancer patients with abnormal glucose metabolism may even become normal. Isolated hyperglycemia 2 hours after glucose loading is common, and OGTT should be made for breast cancer patients at initial diagnosis and during chemotherapy.
目的
本研究旨在通过口服葡萄糖耐量试验（OGTT）评估女性乳腺癌患者初诊时及化疗期间葡萄糖不耐受的状况及比较情况，同时了解化疗对乳腺癌患者葡萄糖代谢的影响。
方法
2012年12月至2013年10月，79例初诊乳腺癌患者（平均年龄53.2岁）及96例化疗第5或6周期前的乳腺癌患者（平均年龄51.5岁）参与本研究。过夜禁食后，参与者接受OGTT试验，测量空腹及2小时血糖水平，以确定其中未诊断出的糖尿病和糖尿病前期（即空腹血糖受损或糖耐量受损）。女性乳腺癌患者中既往诊断的糖尿病通过自我报告和病历确定。
结果
女性乳腺癌患者初诊时及化疗期间葡萄糖耐量正常、糖尿病前期、糖尿病的总体发生率分别为24.1%和38.5%（p<0.05）、50.6%和28.1%（p<0.05）、25.3%和33.3%（p>0.05），两组间葡萄糖耐量正常和糖尿病前期而非糖尿病的差异具有统计学意义。初诊女性乳腺癌患者中约84%的糖尿病和糖尿病前期以及化疗期间79.7%的此类患者需要通过OGTT进行诊断。
结论
乳腺癌患者糖尿病和糖尿病前期的发生率较高。化疗后即使使用了类固醇，一些葡萄糖代谢异常的乳腺癌患者甚至可能恢复正常。葡萄糖负荷后2小时单纯高血糖很常见，初诊及化疗期间的乳腺癌患者应进行OGTT检查。
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