Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, Jiangsu, China.
Graduate School, Nanjing University of Chinese Medicine, Nanjing, 210046, Jiangsu, China.
Support Care Cancer. 2021 Dec;29(12):7461-7469. doi: 10.1007/s00520-021-06321-7. Epub 2021 Jun 3.
To identify the association between diabetes mellitus (DM) and the risk of chemotherapy-induced peripheral neuropathy (CIPN) through a systematic review and meta-analysis.
An electronic literature search was conducted in PubMed, Embase, Web of Science, the Wanfang database, the VIP Journals database (CQVIP), the China National Knowledge Infrastructure (CNKI) database, and the China Biology Medicine database (Sinomed) between January 2010 and January 2021. Articles were included if they investigated CIPN and DM. Stata 15.1 was used to analyze the data.
We examined 8923 cancer patients from 25 studies comprising 9 cohort studies and 16 case-control studies. Meta-analysis showed that there was a statistically significant positive correlation between DM and CIPN (odds ratio [OR] = 1.60, 95% confidence interval [CI] = 1.38-1.85, P < 0.001). Egger's test (P = 0.824) showed no evidence of publication bias. The positive associations did not significant differ by study type, study quality, evaluation instrument, and type of antineoplastic drug. Omission of any single study had little effect on the combined risk estimate. Little evidence of heterogeneity was observed.
This meta-analysis provides evidence of a significant positive association between DM and risk of CIPN. Furthermore, a more detailed evaluation is warranted for cancer patients with diabetes when they are treated with antineoplastic drugs that have the potential to cause peripheral neuropathy.
通过系统评价和荟萃分析，确定糖尿病（DM）与化疗诱导的周围神经病变（CIPN）风险之间的关联。
在 2010 年 1 月至 2021 年 1 月期间，在 PubMed、Embase、Web of Science、万方数据库、维普期刊全文数据库（CQVIP）、中国知网（CNKI）数据库和中国生物医学文献数据库（Sinomed）中进行了电子文献检索。如果文章调查了 CIPN 和 DM，则将其纳入。使用 Stata 15.1 分析数据。
我们从 25 项研究中检查了 8923 名癌症患者，这些研究包括 9 项队列研究和 16 项病例对照研究。荟萃分析显示，DM 与 CIPN 之间存在统计学上显著的正相关（比值比[OR] = 1.60，95%置信区间[CI] = 1.38-1.85，P < 0.001）。Egger 检验（P = 0.824）未显示存在发表偏倚的证据。阳性关联在研究类型、研究质量、评估工具和抗肿瘤药物类型方面没有显著差异。排除任何一项单独的研究对联合风险估计的影响不大。观察到的异质性证据很少。
这项荟萃分析提供了证据，表明 DM 与 CIPN 风险之间存在显著的正相关。此外，当患有可能导致周围神经病变的抗肿瘤药物的糖尿病癌症患者接受治疗时，需要进行更详细的评估。
