机构：[1]Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy ofMedical Sciences and Peking Union Medical College, Beijing, China[2]Cancer Center of the First Hospital of Jilin University, Changchun, China[3]Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China[4]Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China[5]Department of Comprehensive Oncology, Huanxing Cancer Hospital, Beijing, China[6]Department of Medical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China[7]Department of Gastrointestinal Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China[8]Department of Surgery, The First Affiliated Hospital of SunYat-sen University, Guangzhou, China中山大学附属第一医院[9]Department of Clinical Nutrition, West China Hospital of Sichuan University, Chengdu, China四川大学华西医院[10]Department of Gastrointestinal Oncology, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute andHospital, National Clinical Research Center for Cancer, Tianjin, China[11]Department of Nutrition and Metabolism of Oncology, Affiliated Provincial Hospital of Anhui Medical University, Hefei, China[12]Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China[13]Department of Gastrointestinal Surgery, Institute of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, China昆明医科大学附属第一医院[14]Department of Clinical Nutrition, The First People's Hospital of Kashi, Xinjiang, China[15]Department of Clinical Nutrition, Chongqing General Hospital, Chongqing, China[16]Department of Colorectal and Anal Surgery, Huizhou Municipal Central Hospital, Huizhou, China[17]Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China[18]Department of Oncology, Xingtai People’s Hospital, Hebei Medical University, Xingtai, China[19]The First Department of the Tumor Hospital of Harbin Medical University, Harbin, China[20]Department of Nutrition, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China广东省人民医院[21]Department of Oncology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China河南省肿瘤医院[22]Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China[23]Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi, China[24]The Fourth Affiliated Hospital, Harbin Medical University, Harbin, China[25]Cancer Center, The First People's Hospital of Foshan, Foshan, China[26]Department of Gastrointestinal Tumor Surgery, The First Affiliated Hospital, Xiamen University, Xiamen, China[27]Department of Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China[28]Department of Nutrition, Tianjin Third Central Hospital, Tianjin, China[29]Department of Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China[30]Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China[31]Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China[32]Department of Radiation and Medical Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China[33]Department of Clinical Nutrition, Peking University Cancer Hospital and Institute, Beijing, China[34]Department of Nutrition, Third Affiliated Hospital of Kunming Medical College, Tumor Hospital of Yunnan Province, Kunming, China[35]Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China华中科技大学同济医学院附属同济医院[36]Department of Nutrition, Guangzhou Red Cross Hospital, Guangzhou, China[37]Department of Radiotherapy, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science andTechnology of China, Chengdu, China四川省肿瘤医院[38]Department of Clinical Nutrition, Clifford Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China[39]Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, China[40]Department of Hepatobiliary Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing, China[41]Department of Nutrition, Daping Hospital & Research Institute of Surgery, Third Military Medical University, Chongqing, China[42]Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, The 9th Clinical College, Beijing, China
The number of cancer patients with diabetes mellitus (DM) is steadily rising. Little is known about the nutritional status of this population. This study characterized the nutritional status and survival of cancer patients with diabetes compared with those without diabetes.A total of 8247 cancer patients were prospectively enrolled from 72 hospitals in China and followed until August 2019. A global estimation of the nutritional status was performed for each participant using standardized tools. The outcomes were cancer-specific survival (CSS) and overall survival (OS).The incidence of diabetes was 7.6% in the whole population. In comparison with the non-DM group, the DM group had greater body weight, but a similar fat-free mass, a lower handgrip strength and a decreased Karnofsky performance score. A higher proportion of patients with diabetes were overweight/obese as indicated by BMI. The percentage of patients who were at risk of malnutrition (evaluated by PG-SGA) was higher in the DM group (score ≥ 4, 56.7% vs 52.9%). Patients with DM showed a worse CSS (4-year CSS, 62% vs 73%) and OS (4-year OS 39% vs 52%). Diabetes was associated with an increased risk of both cancer-specific (hazard ratio (HR) = 1.282, 95% confidence interval (CI) 1.070-1.536) and overall (HR = 1.206, 95% CI 1.040-1.399) mortality.Cancer patients with diabetes had a larger body mass but lower muscle strength, poorer performance status and higher incidence of malnourishment. Diabetes was associated with compromised survival. Tailored nutritional intervention is necessary for this subpopulation of patients.
基金：
The National Key Research and Development Program, Grant/Award Number: 2017YFC1309200
第一作者机构：[1]Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy ofMedical Sciences and Peking Union Medical College, Beijing, China
通讯作者：
通讯机构：[1]Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy ofMedical Sciences and Peking Union Medical College, Beijing, China[2]Cancer Center of the First Hospital of Jilin University, Changchun, China[41]Department of Nutrition, Daping Hospital & Research Institute of Surgery, Third Military Medical University, Chongqing, China[42]Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, The 9th Clinical College, Beijing, China[*1]Department of Nutrition, Daping Hospital & Research Institute of Surgery, Third Military Medical University, Chongqing 400042, China.[*2]Cancer Center of the First Hospital of Jilin University, Changchun, Jilin 130021, China[*3]Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China[*4]Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Haidian District, Beijing 100038, China
推荐引用方式(GB/T 7714)：
Minghua Cong,Wenjie Zhu,Chang Wang,et al.Nutritional status and survival of 8247 cancer patients with or without diabetes mellitus-results from a prospective cohort study.[J].CANCER MEDICINE.2020,9(20):7428-7439.doi:10.1002/cam4.3397.
APA：
Minghua Cong,Wenjie Zhu,Chang Wang,Zhenming Fu,Chunhua Song...&Hanping Shi.(2020).Nutritional status and survival of 8247 cancer patients with or without diabetes mellitus-results from a prospective cohort study..CANCER MEDICINE,9,(20)
MLA：
Minghua Cong,et al."Nutritional status and survival of 8247 cancer patients with or without diabetes mellitus-results from a prospective cohort study.".CANCER MEDICINE 9..20(2020):7428-7439
