The association between weight change after gastric cancer surgery and type 2 diabetes risk: A nationwide cohort study

IF 9.1 1区医学

Journal of Cachexia, Sarcopenia and Muscle Pub Date : 2023-03-02 DOI:10.1002/jcsm.13206

Yeongkeun Kwon, Jane Ha, Dohyang Kim, Jinseub Hwang, Shin-Hoo Park, Jin-Won Kwon, Sungsoo Park

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引用次数: 1

Abstract

Background

Although gastric cancer patients generally experience drastic weight decrease post-gastrectomy, the impact of weight decrease on type 2 diabetes risk remains unclear. We investigated the type 2 diabetes risk after gastric cancer surgery according to postoperative weight decrease in gastric cancer survivors in South Korea, the country with the world's highest rate of gastric cancer survival.

Methods

This retrospective nationwide cohort study included gastric cancer surgery recipients between 2004 and 2014 who survived for ≥5 years post-surgery. We included patients without a history of diabetes at the time of surgery and those who had not received adjuvant chemotherapy before or after the surgery. Postoperative weight loss was defined as the per cent body weight loss at 3 years post-surgery compared with the baseline. The type 2 diabetes risk was evaluated using Cox regression analyses for five groups of postoperative weight decrease.

Results

In 5618 included gastric cancer surgery recipients (mean age, 55.7 [standard deviation, SD, 10.9] years; 21.9% female; mean body mass index, 23.7 [SD, 2.9] kg/m²), 331 patients (5.9%) developed postoperative type 2 diabetes during follow-up duration of 8.1 years (median; interquartile range, 4.8 years; maximum, 15.2 years). Compared with those who gained weight post-surgery, patients with ≥ −15% to < −10% of postoperative weight decrease (hazard ratio, 0.65; 95% confidence interval, 0.49–0.87; P = 0.004) had the lowest type 2 diabetes risk. A non-linear association occurred between postoperative weight decrease and the type 2 diabetes risk in gastrectomy recipients (Akaike's information criterion [AIC] for non-linear model, 5423.52; AIC for linear model, 5425.61).

Conclusions

A U-shaped non-linear association occurred between the type 2 diabetes risk and postoperative weight decrease in gastric cancer survivors who underwent gastrectomy. The lowest type 2 diabetes risk occurred in patients with ≥ −15% to < −10% of postoperative weight decrease at 3 years.

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胃癌手术后体重变化与2型糖尿病风险之间的关系:一项全国性队列研究

虽然胃癌患者通常在胃切除术后体重急剧下降，但体重下降对2型糖尿病风险的影响尚不清楚。我们根据世界上胃癌存活率最高的国家——韩国胃癌幸存者的术后体重下降，调查了胃癌手术后2型糖尿病的风险。方法本回顾性全国队列研究纳入2004 - 2014年间术后生存≥5年的胃癌手术患者。我们纳入了手术时无糖尿病史的患者以及术前或术后未接受辅助化疗的患者。术后体重减轻定义为术后3年与基线相比体重减轻的百分比。采用Cox回归分析对五组术后体重减轻患者的2型糖尿病风险进行评估。结果5618例胃癌手术患者(平均年龄55.7岁[标准差，SD, 10.9]岁;21.9%的女性;平均体重指数，23.7 [SD, 2.9] kg/m2)，在随访8.1年期间，331例(5.9%)患者发生术后2型糖尿病(中位;四分位数间距4.8年;最长15.2年)。与术后体重增加的患者相比，≥- 15%至<−术后体重下降10%(风险比，0.65;95%置信区间为0.49-0.87;P = 0.004)患2型糖尿病的风险最低。胃切除术患者术后体重下降与2型糖尿病风险之间存在非线性关联(非线性模型的Akaike信息准则[AIC]， 5423.52;AIC用于线性模型，5425.61)。结论胃癌切除术后2型糖尿病风险与术后体重下降呈u型非线性相关。2型糖尿病风险最低的发生在≥- 15% ~ <的患者;−术后3年体重下降10%。

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

Journal of Cachexia, Sarcopenia and Muscle Medicine-Orthopedics and Sports Medicine

自引率

12.40%

发文量

期刊介绍： The Journal of Cachexia, Sarcopenia, and Muscle is a prestigious, peer-reviewed international publication committed to disseminating research and clinical insights pertaining to cachexia, sarcopenia, body composition, and the physiological and pathophysiological alterations occurring throughout the lifespan and in various illnesses across the spectrum of life sciences. This journal serves as a valuable resource for physicians, biochemists, biologists, dieticians, pharmacologists, and students alike.