<p>Fasting blood glucose levels and prognosis in patients with non-small-cell lung cancer: a prospective cohort study in China</p>

Abstract

Purpose Non-small-cell lung cancer (NSCLC) is the most diagnosed lung cancer and is associated with poor prognosis. This study aimed to analyze whether fasting blood glucose (FBG) levels could provide prognostic information in Chinese patients with NSCLC, using the Suzhou Lung Cancer Survival study. Patients and methods A prospective cohort study of adult patients with primary NSCLC was performed. The patients who were hospitalized between January 2016 and April 2018 in two hospitals affiliated with Soochow University were recruited. Patient information, including lifestyle habits and clinical and laboratory data, were collected through face-to-face interviews and evaluation of medical records. Follow-up was initiated from the date of patient enrollment until May 8, 2018 or until patient death. The long-term survival of patients was assessed every 6 months. Patient vital status was confirmed by using hospital records, telephone interview, or local death registration system. Cox proportional hazards regression was used to estimate hazard ratio and 95% confidence interval (CI) for death, with adjustment for cancer stage, medical treatments, smoking, and other potential confounders. Results A total of 387 patients were included in the analysis, and the numbers (percentages) of patients with stages I, II, III, and IV NSCLC were 53 (13.7%), 41 (10.6%), 64 (16.5%), and 215 (55.6%), respectively. The median duration of follow-up was 19.1 months. Compared with patients in the second tertile of FBG, the HRs for mortality were 2.16 (95% CI: 1.26–3.73) and 1.87 (95% CI: 1.03–3.42) for those in the lowest one and diabetic group, respectively. Subgroup analysis according to various patient characteristics confirmed these associations. Conclusion Diabetes and low FBG could be important predictors of death in patients with NSCLC. Maintaining appropriate blood glucose levels may improve prognosis in patients with NSCLC.

Postoperative Fasting Blood Glucose Predicts Prognosis in Stage I-III Colorectal Cancer Patients Undergoing Resection

“…Wu et al conducted a study that included 306 stage 0-III esophageal cancer patients who underwent esophagectomy and found that low postoperative FBG was related to poor survival, and an FBG ≤4 mmol/L was independently linked to poor survival [16]. In our study, we selected patients without a background of a prior preoperative aberrant FBG and found that a low postoperative FBG (<5.11 mmol/L) was associated with poor survival for CRC, which was partially consistent with the results of these studies [16,23]. Notably, we also found that 58.75% (47/80) of patients maintained a relatively high FBG compared to their preoperative value at the 3-6 m follow-up, but FBG failed to present any prognostic value for DFS.…”

“…carried out a prospective cohort study with 387 stage I-IV NSCLC patients and found that patients with a low FBG (<4 mmol/L) had a significantly higher risk of death than those with a high FBG [23]. Wu et al conducted a study that included 306 stage 0-III esophageal cancer patients who underwent esophagectomy and found that low postoperative FBG was related to poor survival, and an FBG ≤4 mmol/L was independently linked to poor survival [16].…”

Epidemiological trends of tracheal, bronchus, and lung cancer at the global, regional, and national levels: a population-based study

“…As regards metabolic risks (high-fasting plasma glucose level), the prognosis in female patients showed an increasing trend, whereas that of males was stable. Metabolic risk-related [ 44 ] ASDR increased in most regions, indicating fasting glucose level elevated TBL cancer death. Some studies provided evidence that diabetes correlated with an elevated risk of lung cancer mortality [ 45 , 46 ], and baseline fasting plasma glucose level was an independent predictor of lung cancer survival [ 47 ].…”

Metabolic Syndrome Components and the Risk of Pulmonary Nodules: A Cross‐sectional Study in Northern China

“…Regarding blood glucose, although there is no clear evidence that it is related to increased risk, it's well known that cancer cells prefer to metabolize glucose by Warburg effect [38]. Additionally, a study showed that low FBG levels and diabetes were associated wth poor survival in patientsits with lung cancer [39]. Moreover, a case-cohort study of Finnish men inferred that higher fasting serum insulin concentrations, as well as the presence of insulin resistance, appear to be associated with an elevated risk of lung cancer development [25].…”