Diabetes increases mortality in patients with pancreatic and colorectal cancer by promoting cachexia and its associated inflammatory status
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Le résumé fourni par la source
Cancer is considered an emerging diabetes complication, with higher incidence and worse prognosis in patients with diabetes. Cancer is frequently associated with cachexia, a systemic metabolic disease causing wasting. It is currently unclear how diabetes affects the development and progression of cachexia. We investigated the interplay between diabetes and cancer cachexia retrospectively in a cohort of 345 patients with colorectal and pancreatic cancer. We recorded body weight, fat mass, muscle mass, clinical serum values, and survival of these patients. Patients were grouped either into diabetic/non-diabetic groups based on previous diagnosis, or into obese/non-obese groups based on body mass index (BMI ≥30 kg/m2 was considered obese). The pre-existence of type 2 diabetes, but not obesity, in patients with cancer led to increased cachexia incidence (80%, compared to 61% without diabetes, p ≤ 0.05), higher weight loss (8.9% vs. 6.0%, p ≤ 0.001), and reduced survival probability (median survival days: 689 vs. 538, Chi square = 4.96, p ≤ 0.05) irrespective of the initial body weight or tumor progression. Patients with diabetes and cancer showed higher serum levels of C-reactive protein (0.919 μg/mL vs. 0.551 μg/mL, p ≤ 0.01) and interleukin 6 (5.98 pg/mL vs. 3.75 pg/mL, p ≤ 0.05) as well as lower serum albumin levels (3.98 g/dL vs. 4.18 g/dL, p ≤ 0.05) than patients with cancer without diabetes. In a sub-analysis of patients with pancreatic cancer, pre-existing diabetes worsened weight loss (9.95% vs. 6.93%, p ≤ 0.01), and increased the duration of hospitalization (24.41 days vs. 15.85 days, p ≤ 0.001). Further, diabetes aggravated clinical manifestations of cachexia, as changes in the aforementioned biomarkers were more pronounced in patients with diabetes and cachexia co-existence, compared to cachectic patients without diabetes (C-reactive protein: 2.300 μg/mL vs. 0.571 μg/mL, p ≤ 0.0001; hemoglobin: 11.24 g/dL vs. 12.52 g/dL, p ≤ 0.05). We show for the first time that pre-existing diabetes aggravates cachexia development in patients with colorectal and pancreatic cancer. This is important when considering cachexia biomarkers and weight management in patients with co-existing diabetes and cancer.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Diabetes increases mortality in patients with pancreatic and colorectal cancer by promoting cachexia and its associated inflammatory status
- Date Crossref
- 01/07/2023
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Heidelberg University Institute for Diabetes and Cancer (IDC) pays non établi dans la noticeUniversité ou école supérieure
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University Hospital Heidelberg pays non établi dans la noticeÉtablissement de santé
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Helmholtz Munich pays non établi dans la noticeStructure de recherche
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Deutsches Diabetes-Zentrum e.V. pays non établi dans la noticeStructure de recherche
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German Center for Diabetes Research pays non établi dans la noticeStructure de recherche
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Heinrich Heine University Düsseldorf pays non établi dans la noticeUniversité ou école supérieure
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TUM Klinikum pays non établi dans la noticeÉtablissement de santé
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Technical University of Munich ZIEL – Institute for Food and Health pays non établi dans la noticeUniversité ou école supérieure
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Fresenius (Germany) pays non établi dans la noticeEntreprise
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Leibniz-Institute for Food Systems Biology at the Technical University of Munich pays non établi dans la noticeStructure de recherche
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Institute for Diabetes and Cancer (IDC) pays non établi dans la noticeStructure de recherche
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School of Medicine Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
Institute for Diabetes and Cancer (IDC) — Heidelberg University, University Hospital Heidelberg et Helmholtz Munich, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.