胃切除术与胃癌幸存者罹患 2 型糖尿病风险之间的关系:一项全国性队列研究。

IF 4.6 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
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引用次数: 0

摘要

目的:胃癌患者在胃切除术后会出现餐后血糖波动,但还没有研究调查胃切除术与胃癌幸存者 2 型糖尿病(T2DM)之间的关系。本研究旨在阐明胃切除术(全胃切除术或次全胃切除术)与T2DM之间的关系。此外,我们还探讨了维生素 B12 的补充是否会调节全胃切除术患者的这一风险:在这项基于韩国国民健康保险服务数据库的全国性大型人群回顾性队列研究中,我们确定了2008年至2015年期间接受胃切除术的年龄大于20岁的患者(n=150,074)和未接受胃切除术的年龄与性别匹配的对照组(n=301,508)。研究采用了考克斯比例危险模型:结果:在胃切除术后2年的中位随访时间(4.4年)内,78,006名受试者中有4,597人(5.9%)患上了T2DM。与匹配对照组相比,全胃切除术患者发生 T2DM 的调整危险比(AHR[95% 置信区间])为 1.34[1.23;1.47]。次全胃切除术后的相应危险比为0.81[0.76;0.86]。在全胃切除术患者中,未接受任何维生素B12补充剂的患者发生T2DM的风险显著增加(AHR=1.60[1.33;1.92]),而胃切除术后持续接受维生素B12补充剂的患者发生T2DM的风险较低(接近统计学意义)(AHR=0.70[0.49;1.01]):这些结果表明,接受胃次全切除术的胃癌患者罹患 T2DM 的风险明显降低,而接受全胃切除术的胃癌患者罹患 T2DM 的风险则明显升高,但持续补充维生素 B12 可降低罹患 T2DM 的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association between gastrectomy and the risk of type 2 diabetes in gastric cancer survivors: A nationwide cohort study

Aim

Postprandial glycemic fluctuations after gastrectomy are seen in patients with gastric cancer but, no studies have investigated the association between gastrectomy and type 2 diabetes mellitus (T2DM) in gastric cancer survivors. This study aimed to elucidate the relationship between gastrectomy (total or subtotal) and incident T2DM. In addition, we explored whether vitamin B12 supplementation modulates this risk among patients who have undergone total gastrectomy.

Methods

In this large nationwide population-based retrospective cohort study using the National Health Insurance Service database of South Korea, we identified patients aged >20 years who underwent gastrectomy from 2008 to 2015 (n = 150,074) and age- and sex-matched controls without gastrectomy (n = 301,508). A Cox proportional hazards model was used.

Results

During the median follow-up duration of 4.4 years after the 2-year time lag after gastrectomy, of the 78,006 subjects, 4,597 (5.9 %) developed T2DM. Compared with matched controls, the adjusted hazard ratio (AHR[95 % confidence interval]) for T2DM of patients with total gastrectomy was 1.34[1.23;1.47]. The corresponding AHR after subtotal gastrectomy was 0.81[0.76;0.86]. Among the patients with total gastrectomy, the risk of T2DM was significantly increased in those who did not receive any vitamin B12 supplementation (AHR=1.60[1.33;1.92]), whereas the risk of T2DM was lower (close to being statistically significant) in those who received continuous vitamin B12 supplementation after gastrectomy (AHR=0.70[0.49;1.01]).

Conclusion

These results show a significantly reduced risk of T2DM in gastric cancer patients undergoing subtotal gastrectomy and a significantly increased risk of T2DM in gastric cancer patients undergoing total gastrectomy, which is mitigated by continuous vitamin B12 supplementation.

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来源期刊
Diabetes & metabolism
Diabetes & metabolism 医学-内分泌学与代谢
CiteScore
12.00
自引率
4.20%
发文量
86
审稿时长
13 days
期刊介绍: A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.
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