Department of Interventional Radiotherapy, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China.
Front Endocrinol (Lausanne). 2021 Oct 7;12:699732. doi: 10.3389/fendo.2021.699732. eCollection 2021.
Urinary bladder carcinoma is common in developed settings, and prognosis may be impacted by lifestyle factors such as excess body weight and diabetes mellitus. The present meta-analysis aimed to systematically collate and analyze evidence on the impact of diabetes and excess BMI on bladder cancer outcomes.
PubMed, Scopus, and Google Scholar databases were screened for relevant studies that examined the association between bladder cancer outcomes and diabetes and/or excess body weight. The primary outcomes for this study were mortality (both all-cause and cancer-specific), risk of cancer progression, and recurrence. Strength of association was presented in the form of pooled adjusted hazard ratios (HR). Statistical analysis was performed using STATA version 16.0.
Twenty-five articles met inclusion criteria. Nine of these examined diabetes mellitus while 16 studied body mass index. All studies were retrospective. Diabetic patients had significantly higher risk for all-cause mortality (HR 1.24, 95% CI: 1.07, 1.44, n=3), cancer specific mortality (HR 1.67, 95% CI: 1.29, 2.16, n=7), disease progression (HR 1.54, 95% CI: 1.15, 2.06, n=8), and recurrence (HR 1.40, 95% CI: 1.32, 1.48, n=8) compared to non-diabetics. No statistically significant risk change for all-cause mortality, cancer specific mortality, disease progression, and recurrence was found for overweight patients. However, obese individuals were at higher risk for disease progression (HR 1.88, 95% CI: 1.41, 2.50, n=3) and recurrence (HR 1.60, 95% CI: 1.06, 2.40, n=7) compared to normal BMI patients.
These findings suggest that diabetes and excess body weight negatively influences bladder cancer prognosis and outcome. The increased risk of mortality due to diabetes was similar to that in the general population. Since retrospective studies are potentially susceptible to bias, future prospective studies on this subject are required.
在发达国家，膀胱癌较为常见，其预后可能受到生活方式因素的影响，如超重和糖尿病。本荟萃分析旨在系统收集和分析有关糖尿病和超重对膀胱癌结局影响的证据。
在 PubMed、Scopus 和 Google Scholar 数据库中筛选了研究膀胱癌结局与糖尿病和/或超重之间关系的相关研究。本研究的主要结局是死亡率（包括全因死亡率和癌症特异性死亡率）、癌症进展风险和复发风险。关联强度以合并调整后的危险比（HR）表示。使用 STATA 版本 16.0 进行统计分析。
25 篇文章符合纳入标准。其中 9 篇研究了糖尿病，16 篇研究了体重指数。所有研究均为回顾性研究。与非糖尿病患者相比，糖尿病患者的全因死亡率（HR 1.24，95%CI：1.07，1.44，n=3）、癌症特异性死亡率（HR 1.67，95%CI：1.29，2.16，n=7）、疾病进展（HR 1.54，95%CI：1.15，2.06，n=8）和复发（HR 1.40，95%CI：1.32，1.48，n=8）的风险显著更高。超重患者的全因死亡率、癌症特异性死亡率、疾病进展和复发风险无统计学显著变化。然而，与正常 BMI 患者相比，肥胖患者疾病进展（HR 1.88，95%CI：1.41，2.50，n=3）和复发（HR 1.60，95%CI：1.06，2.40，n=7）的风险更高。
这些发现表明，糖尿病和超重会对膀胱癌的预后和结局产生负面影响。糖尿病导致的死亡率增加与一般人群相似。由于回顾性研究可能存在偏倚，因此需要对此主题进行未来的前瞻性研究。
