Risk factors for glucocorticoid-induced diabetes mellitus in non-Hodgkin lymphoma after CHOP-like chemotherapy: analysis of 102 cases

Chunyan XIAO; Xiping LIANG; Bingling GUO; Dehong HUANG; Tao YANG; Wenjun ZHANG; Qiying LI; Ying XIANG; Yingyu NAN

doi:10.16016/j.1000-5404.202004073

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Risk factors for glucocorticoid-induced diabetes mellitus in non-Hodgkin lymphoma after CHOP-like chemotherapy: analysis of 102 cases

更新时间：2026-01-09

- Risk factors for glucocorticoid-induced diabetes mellitus in non-Hodgkin lymphoma after CHOP-like chemotherapy: analysis of 102 cases
- Journal of Third Military Medical University Vol. 42, Issue 17, Pages: 1743-1749(2020)
- 作者机构：
- 作者简介：
- 基金信息：
  
  Medical High-end Reserve Talent Training Project of Chongqing Health and Family Planning Commission(2017HBRC016)
- DOI：10.16016/j.1000-5404.202004073
  CLC：
- Received：08 April 2020，
  
  Published：15 September 2020
- 稿件说明：
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Chunyan XIAO, Xiping LIANG, Bingling GUO, et al. Risk factors for glucocorticoid-induced diabetes mellitus in non-Hodgkin lymphoma after CHOP-like chemotherapy: analysis of 102 cases[J]. Journal of Third Military Medical University, 2020, 42(17): 1743-1749.
DOI：

Chunyan XIAO, Xiping LIANG, Bingling GUO, et al. Risk factors for glucocorticoid-induced diabetes mellitus in non-Hodgkin lymphoma after CHOP-like chemotherapy: analysis of 102 cases[J]. Journal of Third Military Medical University, 2020, 42(17): 1743-1749. DOI： 10.16016/j.1000-5404.202004073.

摘要

Abstract

Objective

To investigate the clinical characteristics and related risk factors of glucocorticoid-induced diabetes mellitus (GIDM) in the patients with non-Hodgkin lymphoma (NHL) who were treated with CHOP (doxorubicin

cyclophosphamide

vincristine

prednisone)-like chemotherapy.

Methods

Clinical data of 102 NHL patients undergoing CHOP-like chemotherapy in our department from January 2015 to March 2019 were collected in this study. After the patients with a known history of DM and impaired fasting glucose were excluded

diagnosis of DM was made according to the American Diabetes Association's criteria. The incidence and clinical characteristics of GIDM were observed. The risk factors of secondary GIDM were analyzed by univariate and multivariate analysis.

Results

Forty-four out of 102 patients (43.1%) developed GIDM

and the chemotherapy efficacy in the GIDM patients was worse than that of non-GIDM patients (

0.05). Univariate analysis indicated that age ≥60 years

female

glycated hemoglobin (HbA1c) level ≥6.1%

hypertension at admission or history of hypertension

hypertriglyceridemia

and fasting plasma glucose (FPG) level ≥5.0 mmol/L were high risk factors for GIDM (

0.05). Moreover

multivariate analysis revealed that age ≥60 years

FPG level ≥5.0 mmol/L

HbA1c level ≥6.1%

hypertriglyceridemia and history of hypertension were independent risk factors of GIDM.

Conclusion

NHL patients with older age

higher blood glucose

and accompanied with abnormal blood lipid and blood pressure are more likely to develop GIDM during CHOP-like chemotherapy.

关键词

Keywords

references

ANSELL S M Non-Hodgkin lymphoma: diagnosis and treatment Mayo Clin Proc 2015 90 8 1152 1163 10.1016/j.mayocp.2015.04.025 ANSELL S M. Non-Hodgkin lymphoma: diagnosis and treatment[J]. Mayo Clin Proc, 2015, 90(8): 1152-1163. DOI: 10.1016/j.mayocp.2015.04.025.

SUH S PARK M K Glucocorticoid-induced diabetes mellitus: an important but overlooked problem Endocrinol Metab (Seoul) 2017 32 2 180 189 10.3803/EnM.2017.32.2.180 SUH S, PARK M K. Glucocorticoid-induced diabetes mellitus: an important but overlooked problem[J]. Endocrinol Metab (Seoul), 2017, 32(2): 180-189. DOI:10.3803/EnM.2017.32.2.180.

华优王敏高亚丽糖皮质激素诱发类固醇糖尿病38例临床分析中华皮肤科杂志 2018 51 4 269 273 http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhpf201804007 华优, 王敏, 高亚丽, 等.糖皮质激素诱发类固醇糖尿病38例临床分析[J].中华皮肤科杂志, 2018, 51(4): 269-273.

HUA Y WANG M GAO Y L Clinical analysis of 38 cases of steroid-induced diabetes mellitus due to glucocorticoid treatment Chin J Dermatol 2018 51 4 269 273 http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhpf201804007 HUA Y, WANG M, GAO Y L, et al. Clinical analysis of 38 cases of steroid-induced diabetes mellitus due to glucocorticoid treatment[J]. Chin J Dermatol, 2018, 51(4): 269-273.

中华医学会糖尿病学分会中国2型糖尿病防治指南(2017年版) 中华糖尿病杂志 2018 10 1 4 67 10.3760/cma.j.issn.1674-5809.2018.01.003 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志, 2018, 10(1): 4-67.DOI: 10.3760/cma.j.issn.1674-5809.2018.01.003.

Chinese Diabetes Branch Chinese Medical Association Guidelines for the prevention and control of type 2 diabetes in China (2017 Edition) Chin J Diabetes Mellitus 2018 10 1 4 67 10.3760/cma.j.issn.1674-5809.2018.01.003 Chinese Diabetes Branch Chinese Medical Association. Guidelines for the prevention and control of type 2 diabetes in China (2017 Edition)[J]. Chin J Diabetes Mellitus, 2018, 10(1): 4-67.DOI: 10.3760/cma.j.issn.1674-5809.2018.01.003.

American Diabetes Association 2. classification and diagnosis of diabetes: Standards of medical care in diabetes-2018 Diabetes Care 2018 41 Suppl 1 S13 S27 10.2337/dc18-S002 American Diabetes Association. 2. classification and diagnosis of diabetes: Standards of medical care in diabetes-2018[J]. Diabetes Care, 2018, 41(Suppl 1): S13-S27. DOI:10.2337/dc18-S002.

YANG X B LIN X LU T Fasting plasma glucose levels predict steroid-induced abnormal glucose metabolism in patients with non-diabetic chronic kidney disease: a prospective cohort study Am J Nephrol 2015 41 2 107 115 10.1159/000377642 YANG X B, LIN X, LU T, et al. Fasting plasma glucose levels predict steroid-induced abnormal glucose metabolism in patients with non-diabetic chronic kidney disease: a prospective cohort study[J]. Am J Nephrol, 2015, 41(2): 107-115. DOI:10.1159/000377642.

LEE S Y KURITA N YOKOYAMA Y Glucocorticoid-induced diabetes mellitus in patients with lymphoma treated with CHOP chemotherapy Support Care Cancer 2014 22 5 1385 1390 10.1007/s00520-013-2097-8 LEE S Y, KURITA N, YOKOYAMA Y, et al. Glucocorticoid-induced diabetes mellitus in patients with lymphoma treated with CHOP chemotherapy[J]. Support Care Cancer, 2014, 22(5): 1385-1390. DOI:10.1007/s00520-013-2097-8.

SUGIYAMA T SUGIMOTO T SUZUKI S Current smoking is an independent risk factor for new-onset diabetes mellitus during highdose glucocorticoid treatment Int J Clin Pharmacol Ther 2015 53 8 616 620 10.5414/CP202136 SUGIYAMA T, SUGIMOTO T, SUZUKI S, et al. Current smoking is an independent risk factor for new-onset diabetes mellitus during highdose glucocorticoid treatment[J]. Int J Clin Pharmacol Ther, 2015, 53(8): 616-620. DOI:10.5414/CP202136.

SCHULTZ H ENGELHOLM S A HARDER E Glucocorticoid-induced diabetes in patients with metastatic spinal cord compression Endocr Connect 2018 7 5 719 726 10.1530/EC-18-0088 SCHULTZ H, ENGELHOLM S A, HARDER E, et al. Glucocorticoid-induced diabetes in patients with metastatic spinal cord compression[J]. Endocr Connect, 2018, 7(5): 719-726. DOI:10.1530/EC-18-0088.

ABDELMALAK B B YOU J KURZ A The effects of dexamethasone, light anesthesia, and tight glucose control on postoperative fatigue and quality of life after major noncardiac surgery: a randomized trial J Clin Anesth 2019 55 83 91 10.1016/j.jclinane.2018.12.038 ABDELMALAK B B, YOU J, KURZ A, et al. The effects of dexamethasone, light anesthesia, and tight glucose control on postoperative fatigue and quality of life after major noncardiac surgery: a randomized trial[J]. J Clin Anesth, 2019, 55: 83-91. DOI:10.1016/j.jclinane.2018.12.038.

WALLACE M D METZGER N L Optimizing the treatment of steroid-induced hyperglycemia Ann Pharmacother 2018 52 1 86 90 10.1177/1060028017728297 WALLACE M D, METZGER N L. Optimizing the treatment of steroid-induced hyperglycemia[J]. Ann Pharmacother, 2018, 52(1): 86-90. DOI:10.1177/1060028017728297.

CASTILLO J J MULL N REAGAN J L Increased incidence of non-Hodgkin lymphoma, leukemia, and myeloma in patients with diabetes mellitus type 2: a meta-analysis of observational studies Blood 2012 119 21 4845 4850 10.1182/blood-2011-06-362830 CASTILLO J J, MULL N, REAGAN J L, et al. Increased incidence of non-Hodgkin lymphoma, leukemia, and myeloma in patients with diabetes mellitus type 2: a meta-analysis of observational studies[J]. Blood, 2012, 119(21): 4845-4850. DOI:10.1182/blood-2011-06-362830.

XU J WANG T T Association of diabetes mellitus with non-Hodgkin lymphoma risk: a meta-analysis of cohort studies Hematology 2019 24 1 527 532 10.1080/16078454.2019.1636485 XU J, WANG T T. Association of diabetes mellitus with non-Hodgkin lymphoma risk: a meta-analysis of cohort studies[J]. Hematology, 2019, 24(1): 527-532. DOI:10.1080/16078454.2019.1636485.

WANG Y LIU X YAN P Association between type 1 and type 2 diabetes and risk of non-Hodgkin's lymphoma: a meta-analysis of cohort studies Diabetes Metab 2020 46 1 8 19 10.1016/j.diabet.2019.04.006 WANG Y, LIU X, YAN P, et al. Association between type 1 and type 2 diabetes and risk of non-Hodgkin's lymphoma: a meta-analysis of cohort studies[J]. Diabetes Metab, 2020, 46(1): 8-19. DOI:10.1016/j.diabet.2019.04.006.

YANG W S LI H L XU H L Type 2 diabetes and the risk of non-Hodgkin's lymphoma: a report from two population-based cohort studies in China Eur J Cancer Prev 2016 25 2 149 154 10.1097/CEJ.0000000000000150 YANG W S, LI H L, XU H L, et al. Type 2 diabetes and the risk of non-Hodgkin's lymphoma: a report from two population-based cohort studies in China[J]. Eur J Cancer Prev, 2016, 25(2): 149-154. DOI:10.1097/CEJ.0000000000000150.

HUA F YU J J HU Z W Diabetes and cancer, common threads and missing links Cancer Lett 2016 374 1 54 61 10.1016/j.canlet.2016.02.006 HUA F, YU J J, HU Z W. Diabetes and cancer, common threads and missing links[J]. Cancer Lett, 2016, 374(1): 54-61. DOI:10.1016/j.canlet.2016.02.006.

ATREJA A KALRA S Infections in diabetes J Pak Med Assoc 2015 65 9 1028 1030 http://cn.bing.com/academic/profile?id=d0e944c8be243bbd16b2fabfd409cc81&encoded=0&v=paper_preview&mkt=zh-cn ATREJA A, KALRA S. Infections in diabetes[J]. J Pak Med Assoc, 2015, 65(9): 1028-1030.

HANDWERGER B S FERNANDES G BROWN D M Immune and autoimmune aspects of diabetes mellitus Hum Pathol 1980 11 4 338 352 10.1016/s0046-8177(80)80030-x HANDWERGER B S, FERNANDES G, BROWN D M. Immune and autoimmune aspects of diabetes mellitus[J]. Hum Pathol, 1980, 11(4): 338-352. DOI:10.1016/s0046-8177(80)80030-x.

LIN S Y HSIEH M S CHEN L S Diabetes mellitus associated with the occurrence and prognosis of non-Hodgkin's lymphoma Eur J Cancer Prev 2007 16 5 471 478 10.1097/01.cej.0000236253.93984.8f LIN S Y, HSIEH M S, CHEN L S, et al. Diabetes mellitus associated with the occurrence and prognosis of non-Hodgkin's lymphoma[J]. Eur J Cancer Prev, 2007, 16(5): 471-478. DOI:10.1097/01.cej.0000236253.93984.8f.

DEBATA A YOSHIDA K UJIFUKU K Hyperglycemia is associated with poor survival in primary central nervous system lymphoma patients Tumori 2017 103 3 272 278 10.5301/tj.5000590 DEBATA A, YOSHIDA K, UJIFUKU K, et al. Hyperglycemia is associated with poor survival in primary central nervous system lymphoma patients[J]. Tumori, 2017, 103(3): 272-278. DOI:10.5301/tj.5000590.

LAMAR Z S DOTHARD A KENNEDY L Hyperglycemia during first-line R-CHOP or dose adjusted R-EPOCH chemotherapy for non-Hodgkin lymphoma is prevalent and associated with chemotherapy alteration-a retrospective study Leuk Lymphoma 2018 59 8 1871 1877 10.1080/10428194.2017.1410889 LAMAR Z S, DOTHARD A, KENNEDY L, et al. Hyperglycemia during first-line R-CHOP or dose adjusted R-EPOCH chemotherapy for non-Hodgkin lymphoma is prevalent and associated with chemotherapy alteration-a retrospective study[J]. Leuk Lymphoma, 2018, 59(8): 1871-1877. DOI:10.1080/10428194.2017.1410889.

章敬成刘繁荣胡慧仙趋化因子CCL5与糖尿病相关的弥漫大B细胞淋巴瘤关系的实验研究中国实验血液学杂志 2015 23 5 1325 1330 10.7534/j.issn.1009-2137.2015.05.019 章敬成, 刘繁荣, 胡慧仙, 等.趋化因子CCL5与糖尿病相关的弥漫大B细胞淋巴瘤关系的实验研究[J].中国实验血液学杂志, 2015, 23(5):1325-1330.DOI:10.7534/j.issn.1009-2137.2015.05.019.

ZHANG J C LIU F R HU H X Relationship between chemotactic factor CCL5 and diabet-associated diffuse large B cell lymphoma J Exp Hematol 2015 23 5 1325 1330 10.7534/j.issn.1009-2137.2015.05.019 ZHANG J C, LIU F R, HU H X, et al. Relationship between chemotactic factor CCL5 and diabet-associated diffuse large B cell lymphoma[J]. J Exp Hematol, 2015, 23(5): 1325-1330. DOI:10.7534/j.issn.1009-2137.2015.05.019.

TSENG C H Metformin is associated with a lower risk of non-Hodgkin lymphoma in patients with type 2 diabetes Diabetes Metab 2019 45 5 458 464 10.1016/j.diabet.2019.05.002 TSENG C H. Metformin is associated with a lower risk of non-Hodgkin lymphoma in patients with type 2 diabetes[J]. Diabetes Metab, 2019, 45(5): 458-464. DOI:10.1016/j.diabet.2019.05.002.

OH T J MOON J H CHOI S H Body-weight fluctuation and incident diabetes mellitus, cardiovascular disease, and mortality: a 16-year prospective cohort study J Clin Endocrinol Metab 2019 104 3 639 646 10.1210/jc.2018-01239 OH T J, MOON J H, CHOI S H, et al. Body-weight fluctuation and incident diabetes mellitus, cardiovascular disease, and mortality: a 16-year prospective cohort study[J]. J Clin Endocrinol Metab, 2019, 104(3): 639-646. DOI:10.1210/jc.2018-01239.

SCARONI C ZILIO M FOTI M Glucose metabolism abnormalities in cushing syndrome: from molecular basis to clinical management Endocr Rev 2017 38 3 189 219 10.1210/er.2016-1105 SCARONI C, ZILIO M, FOTI M, et al. Glucose metabolism abnormalities in cushing syndrome: from molecular basis to clinical management[J]. Endocr Rev, 2017, 38(3): 189-219. DOI:10.1210/er.2016-1105.

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