Impact of Diabetes, Hypertension, and Gut Microbial Diversity on Chemotherapy Response and Survival in Cancer Patients: A Prospective Cohort Study.

Q2 Medicine

Asian Pacific Journal of Cancer Prevention Pub Date : 2026-09-01 DOI:10.31557/APJCP.2026.27.9.3377

Sobia Nadeem, Rajib Maitra, - Farah, Shovit Dutta, Khaizran Siddiqui, Rabia Zulfiqar, Mamtaz Mariam Asha, Salah Termos

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引用次数: 0

Abstract

Background and aims: Chronic comorbidities, including diabetes mellitus and hypertension, and gut microbial factors may influence chemotherapy response and survival in cancer patients. This study quantitatively evaluated their combined impact. The main objective of this study was to evaluate the impact of diabetes, hypertension, and gut microbial diversity on chemotherapy response and survival in cancer patients.

Methods: A prospective cohort study enrolled 250 adult cancer patients receiving chemotherapy at a tertiary care center in Bangladesh. Clinical, metabolic, and microbiome data were collected at baseline and during treatment. Chemotherapy response was assessed by RECIST 1.1 criteria, while progression-free survival (PFS) and overall survival (OS) were recorded. Gut microbial diversity was measured using 16S rRNA sequencing. Statistical analyses included chi-square tests, t-tests, Kaplan-Meier survival analysis, and multivariable Cox regression.

Results: Among participants, 32.8% had diabetes and 38.4% had hypertension. Objective response rates (CR+PR) were lower in patients with diabetes (41.5%) and hypertension (45.8%) compared with non-diabetic (57.1%) and normotensive (55.8%) patients (p < 0.05). Responders exhibited significantly lower HbA1c, fasting glucose, and systolic blood pressure than non-responders (p < 0.01). Higher gut microbial alpha diversity was observed in responders (Shannon index 4.1 ± 0.6) versus non-responders (3.4 ± 0.7; p < 0.001). Median PFS and OS were shorter in patients with diabetes (8.6 and 18.4 months) and hypertension (9.1 and 20.2 months) compared with those without comorbidities (12.9 and 26.7 months; 13.4 and 27.9 months, respectively). Multivariable analysis confirmed diabetes (aHR 1.58), hypertension (aHR 1.41), low microbial diversity (aHR 1.76), and advanced tumor stage (aHR 2.34) as independent predictors of worse survival (all p < 0.05).

Conclusions: Diabetes, hypertension, and reduced gut microbial diversity are associated with poorer chemotherapy response and survival outcomes. Integrated management of metabolic and cardiovascular comorbidities, alongside microbiome-informed interventions, may enhance treatment efficacy and patient survival.

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糖尿病、高血压和肠道微生物多样性对癌症患者化疗反应和生存的影响：一项前瞻性队列研究

背景与目的：慢性合并症，包括糖尿病和高血压，以及肠道微生物因素可能影响癌症患者的化疗反应和生存。本研究定量评估了它们的综合影响。本研究的主要目的是评估糖尿病、高血压和肠道微生物多样性对癌症患者化疗反应和生存的影响。方法：一项前瞻性队列研究纳入了250名在孟加拉国三级保健中心接受化疗的成年癌症患者。在基线和治疗期间收集临床、代谢和微生物组数据。根据RECIST 1.1标准评估化疗反应，同时记录无进展生存期（PFS）和总生存期（OS）。采用16S rRNA测序法测定肠道微生物多样性。统计分析包括卡方检验、t检验、Kaplan-Meier生存分析和多变量Cox回归。结果：参与者中32.8%患有糖尿病，38.4%患有高血压。客观缓解率（CR+PR）糖尿病患者（41.5%）和高血压患者（45.8%）低于非糖尿病患者（57.1%）和正常患者（55.8%）（p < 0.05）。有反应者的HbA1c、空腹血糖和收缩压明显低于无反应者（p < 0.01）。应答者的肠道微生物α多样性（Shannon指数4.1±0.6）高于无应答者（3.4±0.7;p < 0.001）。糖尿病患者（8.6个月和18.4个月）和高血压患者（9.1个月和20.2个月）的中位PFS和OS均短于无合并症患者（12.9个月和26.7个月；13.4个月和27.9个月）。多变量分析证实，糖尿病（aHR 1.58）、高血压（aHR 1.41）、低微生物多样性（aHR 1.76）和肿瘤分期晚期（aHR 2.34）是较差生存的独立预测因素（均p < 0.05）。结论：糖尿病、高血压和肠道微生物多样性减少与较差的化疗反应和生存结果相关。代谢和心血管合并症的综合管理，加上微生物组干预，可能会提高治疗效果和患者生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian Pacific Journal of Cancer Prevention 医学-肿瘤学

CiteScore

2.80

自引率

0.00%

发文量

779

审稿时长

3 months

期刊介绍： Cancer is a very complex disease. While many aspects of carcinoge-nesis and oncogenesis are known, cancer control and prevention at the community level is however still in its infancy. Much more work needs to be done and many more steps need to be taken before effective strategies are developed. The multidisciplinary approaches and efforts to understand and control cancer in an effective and efficient manner, require highly trained scientists in all branches of the cancer sciences, from cellular and molecular aspects to patient care and palliation. The Asia Pacific Organization for Cancer Prevention (APOCP) and its official publication, the Asia Pacific Journal of Cancer Prevention (APJCP), have served the community of cancer scientists very well and intends to continue to serve in this capacity to the best of its abilities. One of the objectives of the APOCP is to provide all relevant and current scientific information on the whole spectrum of cancer sciences. They aim to do this by providing a forum for communication and propagation of original and innovative research findings that have relevance to understanding the etiology, progression, treatment, and survival of patients, through their journal. The APJCP with its distinguished, diverse, and Asia-wide team of editors, reviewers, and readers, ensure the highest standards of research communication within the cancer sciences community across Asia as well as globally. The APJCP publishes original research results under the following categories: -Epidemiology, detection and screening. -Cellular research and bio-markers. -Identification of bio-targets and agents with novel mechanisms of action. -Optimal clinical use of existing anti-cancer agents, including combination therapies. -Radiation and surgery. -Palliative care. -Patient adherence, quality of life, satisfaction. -Health economic evaluations.