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

Authors Yang JR, Chen GC, Xu JY, Ling CJ, Yu N, Yang J, Zeng DX, Gu MJ, Li DP, Zhang YS, Qin LQ

Received 26 March 2019

Accepted for publication 5 July 2019

Published 23 July 2019 Volume 2019:12 Pages 5947—5953


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Nicola Silvestris

Jin-Rong Yang,1 Guo-Chong Chen,1 Jia-Ying Xu,2 Chen-Jie Ling,1 Na Yu,3 Jing Yang,4 Da-Xiong Zeng,5 Min-Jing Gu,6 Da-Peng Li,6 Yu-Song Zhang,3 Li-Qiang Qin1

1Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou 215123, People’s Republic of China; 2Institute of Quantitative Biology and Medicine, State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Soochow University, Suzhou 215123, People’s Republic of China; 3Department of Oncology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, People’s Republic of China; 4Department of Clinical Nutrition, The First Affiliated Hospital of Soochow University, Suzhou 215031, People’s Republic of China; 5Department of Respiration, The First Affiliated Hospital of Soochow University, Suzhou 215031, People’s Republic of China; 6Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215031, People’s Republic of China

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.

Keywords: non-small cell lung cancer, fasting blood glucose, diabetes, survival

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