Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 13:15:2039-2049.
doi: 10.2147/DMSO.S370017. eCollection 2022.

Influence of Hyperglycemia on the Prognosis of Patients with Diffuse Large B-Cell Lymphoma

Weiling Zhou  1 , Weijing Li  2 , Cuiying He  2 , Ruijuan Ma  2 , Qian Gao  1 , Yuan Wang  1 , Lei Feng  1 , Lihong Liu  2
Affiliations

Influence of Hyperglycemia on the Prognosis of Patients with Diffuse Large B-Cell Lymphoma

Weiling Zhou et al. Diabetes Metab Syndr Obes. .

Abstract

Purpose: To explore the effects of primary and secondary hyperglycemia and the application of the hypoglycemic drug metformin on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).

Methods: We performed a retrospective analysis of 1767 DLBCL patients.Cox regression method was used for analysis to evaluate the prognostic factors, and the Kaplan-Meier method was used to draw a survival curve to analyze the effect of hyperglycemia and the hypoglycemic drug metformin on the progression-free survival (PFS) and overall survival (OS) of DLBCL patients.

Results: Our study showed that patients with hyperglycemia tend to have higher age (age>60 years), high body mass index (BMI)(≥24kg/m2), late Ann Arbor stage (III-IV), high international prognostic index (IPI) (3-5 score), high lactic dehydrogenase (LDH) level (>250U/L), bulky disease and comorbidity. Hyperglycemia affects the survival time of the DLBCL population (PFS: adjusted HR 1.41, 95% CI: 1.16-1.70, P <0.001, OS: adjusted HR 1.33, 95% CI:1.09-1.61, P=0.004).Compared with the non-hyperglycemia group, the secondary hyperglycemia increase affects the prognosis of the DLBCL population (P<0.001). Compared with the secondary hyperglycemia group, the primary hyperglycemia group has a poor prognosis (P<0.05). For patients with DLBCL and hyperglycemia (732 patients in total), the use of metformin can improve their PFS and OS (PFS: adjusted HR 0.69, 95% CI: 0.49-0.96, P=0.028, OS: adjusted HR 0.68, 95% CI: 0.49-0.95, P=0.024).

Conclusion: Hyperglycemia and secondary hyperglycemia are related to the poor prognosis of DLBCL population.For patients with DLBCL combined with hyperglycemia, the application of metformin can improve survival rate.

Keywords: death; diffuse large B-cell lymphoma; hyperglycemia; metformin; prognosis; recrudescence.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Kaplan–Meier survival curve of the two cohorts. Description: (A) PFS regarding non-hyperglycemia group and hyperglycemia group. (B) OS regarding non-hyperglycemia group and hyperglycemia group.
Figure 2
Figure 2
Kaplan–Meier survival curve of the three cohorts. Description: (A) PFS regarding primary hyperglycemia group, secondary hyperglycemia group and non- hyperglycemia group. (B) OS regarding primary hyperglycemia group, secondary hyperglycemia group and non-hyperglycemia group.
Figure 3
Figure 3
Kaplan–Meier survival curve of the two cohorts. Description: (A) PFS regarding the metformin group and the non-metformin group. (B) OS regarding the metformin group and the non-metformin group. Metformin group refers to taking single-drug metformin or metformin combined with other hypoglycemic drugs, non-metformin group refers to never taking metformin (other hypoglycemic drugs are not excluded).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Liu Y, Barta SK. Diffuse large B-cell lymphoma: 2019 update on diagnosis, risk stratification, and treatment. Am J Hematol. 2019;94(5):604–616. doi:10.1002/ajh.25460 - DOI - PubMed
    1. International Diabetes Federation. IDF Diabetes Atlas. 10th ed. Brussels, Belgium: International Diabetes Federation; 2021.
    1. Tsilidis KK, Ioannidis JP. Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies. BMJ. 2015;11(1):350. doi:10.1136/bmj.g7607 - DOI - PubMed
    1. Wang C, Wang X, Gong G, et al. Increased risk of hepatocellular carcinoma in patients with diabetes mellitus: a systematic review and meta-analysis of cohort studies. Int J Cancer. 2012;130(7):1639–1648. doi:10.1002/ijc.26165 - DOI - PubMed
    1. Li D, Yeung SC, Has San MM, et al. Antidiabetic therapies affect risk of pancreatic cancer. Gastroenterology. 2009;137(2):482–488. doi:10.1053/j.gastro.2009.04.013 - DOI - PMC - PubMed

LinkOut - more resources