Department of Gastroenterology, The Dingli Clinical College of Wenzhou Medical University, Wenzhou, China.
Center for Rehabilitation Medicine and Department of Anesthesiology, Zhejiang Provincial People's Hospital, Hangzhou, China.
Horm Metab Res. 2023 May;55(5):333-342. doi: 10.1055/a-2038-5830. Epub 2023 Apr 3.
Metabolic syndrome (MetS) is suggested to participate in the pathogenesis and progress of some cancers via inducing low-grade systemic inflammation. However, the influence of MetS on patients with gastric cancer (GC) remains not fully determined. A systematic review and meta-analysis was therefore performed to evaluate the influence of MetS on clinical outcomes of patients with GC. A search of PubMed, Embase, Web of Science, Wanfang, and CNKI retrieved relevant cohort studies from the inception of the databases to October 11, 2022. We pooled the results using a random-effects model that incorporates heterogeneity. In the meta-analysis, 6649 patients with GC were included, and all of them received gastrectomy. A total of 1248 (18.8%) patients had MetS at baseline. Pooled results showed that MetS was associated with higher risks of postoperative complications [risk ratio (RR): 2.41, 95% confidence interval (CI): 1.85 to 3.14, p<0.001; I2=55%], overall mortality (RR: 1.73, 95% CI: 1.85 to 3.14, p<0.001; I2=77%), and recurrence of GC (RR: 2.00, 95% CI: 1.10 to 3.63, p=0.02; I2=39%). Subgroup analyses showed similar results in prospective and retrospective cohort studies and in studies with MetS diagnosed with the Chinese Diabetes Society criteria and the National Cholesterol Education Program Adult Treatment Panel III criteria (p for subgroup difference all>0.05). In patients with GC after gastrectomy, MetS may be a predictor of high incidence of postoperative complications, cancer recurrence, and overall mortality.
代谢综合征（MetS）被认为通过诱导低度全身炎症参与某些癌症的发病机制和进展。然而，MetS 对胃癌（GC）患者的影响仍未完全确定。因此，进行了系统评价和荟萃分析，以评估 MetS 对 GC 患者临床结局的影响。通过搜索 PubMed、Embase、Web of Science、万方和中国知网，从数据库建立到 2022 年 10 月 11 日检索了相关队列研究。我们使用包含异质性的随机效应模型合并结果。在荟萃分析中，纳入了 6649 例接受胃切除术的 GC 患者。基线时共有 1248 例（18.8%）患者患有 MetS。汇总结果显示，MetS 与术后并发症风险增加相关[风险比（RR）：2.41，95%置信区间（CI）：1.85 至 3.14，p<0.001；I2=55%]、总死亡率（RR：1.73，95% CI：1.85 至 3.14，p<0.001；I2=77%）和 GC 复发（RR：2.00，95% CI：1.10 至 3.63，p=0.02；I2=39%）。亚组分析显示，前瞻性和回顾性队列研究以及使用中国糖尿病协会标准和国家胆固醇教育计划成人治疗专家组 III 标准诊断 MetS 的研究中均得出类似结果（p 亚组差异均>0.05）。在接受胃切除术后的 GC 患者中，MetS 可能是术后并发症、癌症复发和总死亡率高发生率的预测因子。
