Lipid levels and insulin resistance markers in gastric cancer patients: diagnostic and prognostic significance

Abstract

Gastric cancer (GC) is a highly heterogeneous and aggressive malignant tumor that seriously affects the life safety of people all over the world. Its early manifestations are subtle. The present study aimed to investigate the clinical significance of serum lipid profiles, insulin resistance markers including the triglyceride-glucose (TyG) index and the atherosclerotic index (AI), in GC patients. A retrospective analysis encompassed 215 GC patients and 827 healthy individuals. The study results show that the total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein levels, and the TyG index of GC patients were significantly lower than those of the control group before and after propensity score matching analysis. In the GC group, the levels of CEA, CA199, CA125, and CA724 tumor markers were higher than those in the healthy control group. Patients in advanced stages exhibited lower serum levels of serum lipids and TyG index compared to those in early stages. ROC analysis revealed that the TyG index, CA125, and CA199 combination yielded the highest positive prediction rate for GC at 98.6%. TyG index is significantly associated with the risk of adverse reactions after chemotherapy (OR = 1.104, 95% CI 1.028-1.186, P < 0.01). Multiple tumor markers and the TyG index combined detection showed correlations with five adverse reactions caused by chemotherapy (r < 0.6, P < 0.05). Preoperative lipid profiles in the serum show a strong correlation with patients diagnosed with GC. Evaluating a combination of various serum lipids and cancer markers significantly improves diagnostic precision for GC and the ability to predict chemotherapy side effects.

Keywords: Diagnostic marker; Gastric cancer; Serum lipids; Triglyceride-glucose index.

Fig. 1

Serum lipid, TyG index, AI, and tumor markers in GC patients and healthy participants. Serum lipids including TC, TG, HDL-C, and LDL-C (a), TyG index, and AI (b) in all research subjects. CEA, CA199, CA125, and CA724 (c), Data were presented as median (interquartile range [IQR]), analyzed by Pearson’s χ2 test. *P < 0.05, **P < 0.01, ***P < 0.001

Fig. 2

Levels of blood lipids, TyG index, AI, and tumor markers in gastric cancer patients of different genders and healthy controls. Lipid indices include TC, TG, HDL-C, and LDL-C in male (a) and female (b), TyG index and AI in male (c) and female (d). CEA, CA199, CA125, and CA724 in Male (e) and female (f), the data to the median (interquartile range (IQR are much less)) said that using Pearson chi-square test. *p < 0.05, **p < 0.01, ***p < 0.001

Fig. 3

Serum lipid, TyG index and AI in GC patients and healthy participants after PSM. After PSM analysis, serum lipids (a), TyG index, AI (b), and tumor markers (c) were measured in GC patients and healthy controls. Lipid measures included TC, TG, HDL, and LDL-C in male (d) and female (f), and TyG index and AI in male (e) and female (g). Data were expressed as median (interquartile range less than IQR) and analyzed using the Pearson chi-square test. *p < 0.05, **p < 0.01, ***p < 0.001

Fig. 4

The levels of TC (a), TG (b), LDL-C (d), HDL-C (e), TyG index, AI index (f), and tumor markers (c) in gastric cancer patients before and after surgery were compared. Data were presented as median (interquartile range less than IQR) and analyzed using the Pearson chi-square test. *p < 0.05, **p < 0.01, ***p < 0.001

Fig. 5

Various combined diagnostic indicators for GC patients