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癌症死亡率与糖尿病的全身炎症标志物的关联:来自全国健康和营养调查的证据。

Association of systemic inflammation markers in cancer mortality with diabetes: evidence from National Health and Nutrition Examination Survey.

机构信息

Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China.

出版信息

Acta Diabetol. 2024 Nov;61(11):1403-1412. doi: 10.1007/s00592-024-02301-5. Epub 2024 May 27.

Abstract

AIMS

Inflammation plays a crucial role in the interconnection between diabetes and cancer. Our study seeks to investigate the predictive value of inflammatory indices concerning overall survival (OS) among diabetic cancer patients.

METHODS

We analyzed data from the National Health and Nutrition Examination Survey between 1999 and 2020. Using four immune-related markers, we employed the log-rank method, multivariate Cox regression, and subgroup analysis to explore the predictive capacity of these markers for OS among adult individuals with diabetes and cancer.

RESULTS

Our study identified four systemic immune-inflammatory indices that demonstrated significant predictive potential for OS among diabetic cancer patients, namely systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio (all p values < 0.05). Notably, these inflammatory biomarkers still maintain their predictive value after adjusting potential confounding factors. The analysis using restrictive cubic splines revealed significant non-linear relationships between inflammatory biomarkers and OS.

CONCLUSION

The findings presented in this study underscore the potential of inflammatory markers as prognostic indicators and their crucial role in enhancing risk assessment for diabetic patients with cancer.

摘要

目的

炎症在糖尿病和癌症之间的相互关系中起着至关重要的作用。本研究旨在探讨炎症指标对糖尿病合并癌症患者总生存期(OS)的预测价值。

方法

我们分析了 1999 年至 2020 年期间国家健康和营养检查调查的数据。使用四个免疫相关标志物,我们采用对数秩检验、多变量 Cox 回归和亚组分析来探讨这些标志物对糖尿病合并癌症的成年人 OS 的预测能力。

结果

我们的研究确定了四个全身性免疫炎症指数,它们对糖尿病合并癌症患者的 OS 具有显著的预测潜力,即全身性免疫炎症指数、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值和淋巴细胞与单核细胞比值(所有 p 值均<0.05)。值得注意的是,在调整潜在混杂因素后,这些炎症生物标志物仍然保持其预测价值。限制性立方样条分析显示炎症标志物与 OS 之间存在显著的非线性关系。

结论

本研究的结果强调了炎症标志物作为预后指标的潜力及其在增强糖尿病合并癌症患者风险评估中的关键作用。

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