血糖水平在胰腺癌患者中的预后作用：一项系统评价和荟萃分析
The Prognostic Role of Glycemia in Patients With Pancreatic Carcinoma: A Systematic Review and Meta-Analysis.
作者信息
Wang Xiaofang, Xu Wanfeng, Hu Xiaoru, Yang Xianghong, Zhang Mingming
机构信息
Department of Clinical Oncology and Department of Hospice Care, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China.
出版信息
Front Oncol. 2022 Feb 10;12:780909. doi: 10.3389/fonc.2022.780909. eCollection 2022.
BACKGROUND
Fasting blood glucose and glycated hemoglobin (HbA1c) levels are associated with the risk of pancreatic cancer.
AIM
To examine the relationship between perioperative glucose and HbA1c levels and prognosis in patients with pancreatic cancer.
METHODS
PubMed, Embase, and the Cochrane Library were queried for potentially eligible studies published up to May 2021. The exposures were perioperative fasting glucose and HbA1c levels. The primary outcome was survival. The secondary outcome was complications. All analyses were performed using the random-effects model.
RESULTS
Ten studies (48,424 patients) were included. The pre-operative (HR=1.10, 95%CI: 0.89-1.35; I = 45.1%, P=0.078) and postoperative (HR=1.19, 95%CI: 0.92-1.54; I = 67.9%, P=0.001) blood glucose levels were not associated with the survival to pancreatic cancer. Similar results were observed for HbA1c (HR=1.09, 95%CI: 0.75-1.58; I = 64.2%, P=0.039), fasting blood glucose (FBG)/HbA1c (HR=1.16, 95%CI: 0.67-1.68; I = 0.0%, P=0.928), and FBG (HR=1.75, 95%CI: 0.81-3.75; I = 79.4%, P=0.008). Pre-operative blood glucose levels were not associated with postoperative complications (OR=0.90, 95%CI: 0.52-1.56), but postoperative glucose levels were associated with postoperative complications (OR=3.06, 95%CI: 1.88-4.97; I = 0.0%, P=0.619).
CONCLUSION
Blood glucose, FBG, and HbA1c levels are not associated with the survival of patients with pancreatic cancer. Postoperative blood glucose levels could predict postoperative complications.
背景
空腹血糖和糖化血红蛋白（HbA1c）水平与胰腺癌风险相关。
目的
探讨胰腺癌患者围手术期血糖和HbA1c水平与预后的关系。
方法
检索PubMed、Embase和Cochrane图书馆，查找截至2021年5月发表的潜在合格研究。暴露因素为围手术期空腹血糖和HbA1c水平。主要结局为生存。次要结局为并发症。所有分析均采用随机效应模型。
结果
纳入10项研究（48424例患者）。术前（HR=1.10，95%CI：0.89-1.35；I²=45.1%，P=0.078）和术后（HR=1.19，95%CI：0.92-1.54；I²=67.9%，P=0.001）血糖水平与胰腺癌生存无关。HbA1c（HR=1.09，95%CI：0.75-1.58；I²=64.2%，P=0.039）、空腹血糖（FBG）/HbA1c（HR=1.16，95%CI：0.67-1.68；I²=0.0%，P=0.928）和FBG（HR=1.75，95%CI：0.81-3.75；I²=79.4%，P=0.008）也观察到类似结果。术前血糖水平与术后并发症无关（OR=0.90，95%CI：0.52-1.56），但术后血糖水平与术后并发症有关（OR=3.06，95%CI：1.88-4.97；I²=0.0%，P=0.619）。
结论
血糖、FBG和HbA1c水平与胰腺癌患者的生存无关。术后血糖水平可预测术后并发症。
Zotero 插件