Impact of diabetes mellitus on the risk and survival of nasopharyngeal carcinoma: a meta-analysis

Abstract

BackgroundDiabetes mellitus (DM) has been identified to be both a risk factor and a prognostic factor in a variety of malignancies, but its association with the risk and outcome of nasopharyngeal carcinoma (NPC) is still unclear. To elucidate this issue, we systematically reviewed the evidence concerning the association between DM status and NPC.Materials and methodsWe identified studies by a literature search of PubMed, Embase, and ISI Web of Knowledge through May 31, 2017, and by searching the reference lists of pertinent articles. Odds ratios (ORs) and hazard ratios (HRs) with 95% CIs were used to estimate the effect size. Heterogeneity across studies was evaluated by the Cochran’s Q and I2 statistics.ResultsA total of nine studies were included. Four studies with a total sample size of 221,611 reported the effect of DM on NPC risk, and the other five studies with a sample size of 9,442 reported the impact of DM on survival in NPC patients. All included studies were retrospective, and mostly conducted in Asian populations. Meanwhile, condition of metformin usage was not considered in all studies. A pooled OR of 0.65 (95% CI: 0.43–0.98, P=0.04) revealed an inverse association between DM and NPC. Additionally, pooled analyses of studies investigating the prognosis value of DM revealed that preexisting DM had no effect on overall survival (HR =1.17, 95% CI: 0.94–1.46, P=0.16), local recurrence-free survival (HR =1.16, 95% CI: 0.80–1.67, P=0.44), and distant metastasis-free survival (HR =1.14, 95% CI: 0.92–1.40, P=0.22).ConclusionOur results suggested that DM patients might have decreased NPC risk, and have little impact on prognosis of NPC patients. This conclusion should be limited to Asian population. Our results also suggest that more attention should be paid to metformin medication in further studies in order to clarify whether the effects of DM on NPC risk and prognosis are influenced by the anticancer effect of metformin.

Prognostic Implication of Metabolic Syndrome in Patients with Nasopharyngeal Carcinoma: A Large Institution-Based Cohort Study from an Endemic Area

“… 23 , 24 A meta-analysis of nine studies showed that diabetes has no impact on NPC prognosis. 25 However, a recent case-control study showed that patients with diabetes have shorter survival than those without diabetes. 26 The prognostic value of different lipoproteins in NPC is different, among which high-density lipoprotein and apolipoprotein A-I are favourable prognosticators, while low-density lipoprotein is an indicator of poor prognosis.…”

Effect of glycosylated hemoglobin protein molecule in treating diabetes

“…Moreover, it can achieve targeted control of blood sugar in diabetic patients, prevent the evolution of diabetes, and reduce the risk of complications. Glycosylated hemoglobin is generally not affected by daily fluctuations in disease, life stress and environment, which just shows blood glucose levels (12)(13). For diabetes, there are also recommendations for the use of medicinal herbs (14).…”

Head and Neck Cancer Types and Risks of Cervical–Cranial Vascular Complications within 5 Years after Radiation Therapy

“…Studies have also demonstrated that hypertension is associated with the risk of oral cavity and laryngeal cancer [ 27 ], and metabolic syndromes are significantly associated with the risk of laryngeal cancer [ 28 ]. By contrast, no overall association was identified between metabolic disorders and NPC [ 29 ], except for a previous study that reported an inverse association between diabetes and NPC [ 30 ]. Our report demonstrated a positive association between the glycated hemoglobin level and the risk of significant CAS development in Cox regression model.…”