Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), 56126 Pisa, Italy.
Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56126 Pisa, Italy.
Int J Environ Res Public Health. 2020 Nov 17;17(22):8501. doi: 10.3390/ijerph17228501.
The relationship between type 2 diabetes mellitus (DM2) and hyperglycemia with cancer patients remains controversial also in the setting of patients with glioblastoma multiforme (GBM), the most common and aggressive form of astrocytoma with a short overall survival (OS) and poor prognosis. A systematic search of two databases was performed for studies published up to 19 August 2020, reporting the OS of patients with DM2 or high blood sugar level and GBM and the clinical risk of diabetic patients for development of GBM. According to PRISMA guidelines, we included a total of 20 papers reporting clinical data of patients with GBM and diabetes and/or hyperglycemia. The aim of this review was to investigate the effect of DM2, hyperglycemia and metformin on OS of patients with GBM. In addition, we evaluated the effect of these factors on the risk of development of GBM. This review supports accumulating evidence that hyperglycemia, rather than DM2, and elevated BMI are independent risk factors for poor outcome and shorter OS in patients with GBM. GBM patients with normal weight compared to obese, and diabetic patients on metformin compared to other therapies, seems to have a longer OS. Further studies are needed to understand better these associations.
2 型糖尿病（DM2）与高血糖与癌症患者之间的关系，即使在多形性胶质母细胞瘤（GBM）患者中也存在争议，GBM 是星形细胞瘤中最常见和侵袭性的一种，总体生存（OS）时间短，预后差。对截至 2020 年 8 月 19 日发表的研究进行了两个数据库的系统检索，报告了患有 DM2 或高血糖的患者以及 GBM 的 OS 以及糖尿病患者发生 GBM 的临床风险。根据 PRISMA 指南，我们共纳入了 20 篇报告 GBM 合并糖尿病和/或高血糖患者临床数据的论文。本综述的目的是探讨 DM2、高血糖和二甲双胍对 GBM 患者 OS 的影响。此外，我们还评估了这些因素对 GBM 发生风险的影响。本综述支持越来越多的证据表明，高血糖而非 DM2 以及升高的 BMI 是 GBM 患者预后不良和 OS 缩短的独立危险因素。与肥胖患者相比，体重正常的 GBM 患者，以及与其他治疗方法相比使用二甲双胍的糖尿病患者，OS 似乎更长。需要进一步的研究来更好地了解这些关联。
