代谢综合征与老年胰腺癌相关性分析

Relationship between metabolic syndrome and pancreatic carcinoma in seniors

目的探讨和分析代谢综合征与老年胰腺癌的关系及老年胰腺癌患者合并代谢综合征的临床特点。方法回顾性分析2009年6月至2013年12月符合胰腺癌诊断标准且年龄大于60岁住院患者178例及同期住院的年龄、性别、身高、体质量匹配的非内分泌系统、非消化系统、非肿瘤相关疾病患者190例的临床资料,进行单因素和多因素logistic分析,分析代谢综合征及其成分与老年胰腺癌的相互关系及老年胰腺癌患者合并代谢综合征的临床特点。结果老年胰腺癌患者合并糖尿病、高三酰甘油、空腹血糖升高或代谢综合征与对照组比较差异有统计学意义,OR值分别为2.013、1.411、2.251、2.92,新发糖尿病(DM,病程≤2年)与老年胰腺癌的关联性高于长期糖尿病患者。胰腺癌组与对照组合并糖尿病者糖化血红蛋白水平与CA199均升高,两组比较差异有统计学意义(P<0.05),且胰腺癌组CA199升高与糖化血红蛋白水平关系密切。结论代谢综合征及其组成成分糖尿病、空腹血糖、三酰甘油、糖化血红蛋白是老年人患胰腺癌的独立危险因素,合并代谢综合征的老年胰腺癌患者临床特点无特异性。

Objective To study the relationship between metabolic syndrome( MS) and pancreatic carcinoma ( PC) in seniors, and to investigate the clinical characteristics of elderly patients with pancreatic cancer and the metabolic syndrome. Methods This was a retro-spective analysis of the clinical data collected from 368 inpatients admitted to this hospital from June 2009 to December 2013. These 368 in-patients, including 178 patients with pancreatic carcinoma and 190 controls without carcinoma and metabolic disease, were all older than 60. Univariate and multivariate analyses were performed to determine the risk factors of pancreatic carcinoma. The clinical characteristic analysis of older pancreatic carcinoma patients with metabolic syndrome was performed as well. Results Diabetes mellitus, serum triglyceride level, the level of higher fasting glucose and metabolic syndrome in pancreatic carcinoma group were significantly higher/severer than those in the control group. The odd ratios were 2. 013, 1. 411, 2. 251, and 2. 92, respectively. The analysis indicated that the correlation between pan-creatic cancers and new onset diabetes mellitus ( DM, course of 2 years or less) was significantly higher than that of long-term diabetes mel-litus. GHA1c and CA199 levels in both groups increased (PC vs Control, with diabetes mellitus), and the statistic comparison of both groups were significant (P<0. 05). The correlation of CA199 and GHbA1c was high in pancreatic carcinoma group. Conclusion The metabolic syndrome and its components of diabetes, fasting blood sugar, serum triglyceride level, HbA1c may be independent risk factors for pancreatic cancer in elderly patients. However, the lack of characteristic clinical features is common for elderly patients with pancreatic cancer that com-bines with metabolic syndrome.