Monzavi-Karbassi Behjatolah, Gentry Rhonda, Kaur Varinder, Siegel Eric R, Jousheghany Fariba, Medarametla Srikanth, Fuhrman Barbara J, Safar A Mazin, Hutchins Laura F, Kieber-Emmons Thomas
Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205 USA ; Department of Pathology, University of Arkansas for Medical Sciences, 4301 West Markham St., Slot #824, Little Rock, AR 72205 USA.
Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205 USA ; Division of Hematology/Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205 USA.
Cancer Metab. 2016 Apr 6;4:7. doi: 10.1186/s40170-016-0147-7. eCollection 2016.
The effect of moderately elevated blood glucose levels among non-diabetic subjects on cancer prognosis is not well described. The goal of this study was to examine the association of elevated random blood glucose (RBG) levels in non-diabetic breast cancer patients with overall survival (OS) and time to tumor recurrence (TTR).
Forty-nine deaths and 32 recurrences occurred among 148 eligible study subjects during 855.44 person-years of follow-up, with median follow-up of 5.97 years. We observed that patients with elevated RBG levels experienced significantly shorter OS (hazard ratio [HR], 3.01; 95 % confidence interval [CI] (1.70-5.33); P < 0.001) and shorter TTR (HR, 2.08; CI (1.04-4.16); P = 0.04) as compared to patients with non-elevated RBG levels. After controlling for tumor grade, tumor stage, race, and BMI, elevated RBG continued to display high and statistically significant association with shorter OS (HR, 3.50; CI (1.87-6.54); P < 0.001). Adjustment for age, race, and BMI strengthened HR of RBG for TTR. The association of RGB with TTR lost its borderline statistical significance upon controlling for both tumor grade and stage.
The data suggest that elevated blood glucose is associated with poor prognosis of breast cancer patients. Given the potential clinical implication, these findings warrant further investigation.
非糖尿病患者中血糖水平适度升高对癌症预后的影响尚未得到充分描述。本研究的目的是探讨非糖尿病乳腺癌患者随机血糖（RBG）水平升高与总生存期（OS）和肿瘤复发时间（TTR）之间的关联。
在855.44人年的随访期间，148名符合条件的研究对象中有49人死亡，32人复发，中位随访时间为5.97年。我们观察到，与RBG水平未升高的患者相比，RBG水平升高的患者OS显著缩短（风险比[HR]，3.01；95%置信区间[CI]（1.70 - 5.33）；P < 0.001），TTR也缩短（HR，2.08；CI（1.04 - 4.16）；P = 0.04）。在控制肿瘤分级、肿瘤分期、种族和体重指数后，RBG升高与较短的OS仍显示出高度且具有统计学意义的关联（HR，3.50；CI（1.87 - 6.54）；P < 0.001）。对年龄、种族和体重指数进行调整后，RBG对TTR的HR增强。在同时控制肿瘤分级和分期后，RGB与TTR的关联失去了临界统计学意义。
数据表明血糖升高与乳腺癌患者预后不良有关。鉴于其潜在的临床意义，这些发现值得进一步研究。
