纠正糖代谢异常与消化系统恶性肿瘤死亡风险关联的回顾性队列研究

Retrospective cohort analysis of the relationship between correcting abnormal glucose metabolism and controlling the risk of death of digestive system malignant tumors

目的 探讨纠正糖代谢异常与消化系统恶性肿瘤死亡风险之间的关联。方法 采用回顾性队列研究,选取陕西省人民医院2019年1月糖代谢异常患者1 308例,根据有无进行糖代谢纠正治疗分入暴露组(777例)和非暴露组(531例),回顾性随访至2022年12月,对比分析两组患者消化系统肿瘤发生情况及发生肿瘤影响因素。结果 发生消化系统肿瘤患者31例,死亡9例。暴露组消化系统肿瘤发生率(3/777)低于非暴露组(28/531)。暴露组死亡率(1/777)低于非暴露组(8/531)。Cox回归模型分析结果显示纠正糖代谢异常为患者消化系统恶性肿瘤死亡风险保护因素(HR值<1,P<0.05);FBG增高、合并脂代谢异常、脉压差升高、恶性肿瘤家族史、饮酒则表现为患者消化系统恶性肿瘤死亡风险危险因素,(HR值均>1,P<0.05)。结论 纠正糖代谢异常对于减低患者消化系统恶性肿瘤死亡风险具有积极意义,FBG增高、合并脂代谢异常、脉压差升高、恶性肿瘤家族史、饮酒患者应特别注意发生糖代谢异常后及时纠正。

Objective To investigate the relationship between correcting abnormal glucose metabolism and mortality risk of malignant tumors of digestive system.Methods A retrospective cohort study was conducted.1308 patients with abnormal glucose metabolism in our hospital from January 2019 were divided into exposed group(n=777) and non-exposed group(n=531) according to the presence or absence of glucose metabolism correction therapy.The patients were retrospectively followed up until December 2022.The incidence of digestive system tumors and the influencing factors of tumors were compared between the two groups.Results There were 31 patients with digestive system tumor and 9 patients died.The incidence of digestive system tumors was lower in the exposed group(3/777) than in the non-exposed group(28/531).The mortality rate in the exposed group(1/777) was lower than that in the non-exposed group(8/531).Cox regression model analysis showed that correcting abnormal glucose metabolism was a protective factor for the risk of death from malignant tumors of the digestive system in patients(HR value<1,P<0.05);increased FBG,combined abnormal lipid metabolism,increased pulse pressure difference,family history of malignant tumors,and alcohol consumption were shown as risk factors for the risk of death from malignant tumors of the digestive system in patients(HR values>1,P<0.05).Conclusion Correcting abnormal glucose metabolism is of positive significance in reducing the risk of death from malignant tumors of digestive system.Patients with increased FBG,abnormal lipid metabolism,increased pulse pressure difference,family history of malignant tumors and alcohol consumption should pay special attention to correct abnormal glucose metabolism in time.