Effects Of Chemotherapy On Glucose Metabolism In Patients With Hepatic Metastases

Objective To investigate the effect of chemotherapy on blood glucose leveland HbA1c of patients with liver metastaticMethods60cases with liver metastatic receive chemotherapy in ourdepartment were enrolled. blood glucose level and HbA1c before, after1th and3thcycle chemotherapy were detected. to analysis the change of blood glucose level andHbA1C between before and after1th, after1th and before and after3th cyclechemotherapy. Analyses the effect of related clinical factors on blood glucose leveland HbA1c. blood glucose level were detected by GOD PAP and HbA1C weredetermined by HPLC methods. Chemotherapy regimen mainly contain PTX,platinum and5-fu, sustain3cycles.Results60cases with liver metastatic，Compared with before treatment，22cases with liver metastatic blood glucose level rises accounting36.7percent, But didnot meet the diagnostic criteria of diabetes，low blood sugar (hypoglycemia)5casesaccounting8.3percent. HbA1c rises4cases. Among those22cases, impaired glucosetolerance (IGT)9cases, rapid rises in blood glucose13cases accounting59percent.60cases blood glucose level and after1th chemotherapy is higher than that beforechemotherapy.blood glucose level after3th is higher than that after1th， and before3th，（P<0.001）.HbA1c after3th is higher than that before1th，（P<0.001）.Thereis significant ststistic difference，The ratio of fasting blood glucose rise in55andolder patients is higher than that in55less patients, gender and BMI have norelationship with blood glucose rise，（P>0.05）.The ratio of blood glucose elevel risein patients with liver metastatic foci number more than there is higher than that lessthan there, P<0.05,The ratio of blood glucose level rise in patients with tumor sizelarger than5cm is higher than that less than5cm,P<0.05。blood glucose and HbA1Clevel is higher in patients treated with glucocorticoids than not.P<0.05,blood glucoseand HbA1c level is higher in patients with middle liver function damage than liver function damage. Platinum combined with PTX or5-fu had more effect on bloodglucose level.Conclusions (1) Patients with liver metastatic foci receive chemotherapy mayresult in change of blood glucose level, mainly glucose level rise, With the extensionof cycles of chemotherapy, the blood glucose increased，part patients occurs glucoselevel decrease reaction.(2) age is one of the high reasons leading to abnormal glucosemetabolism.(3) the number of liver metastatic foci more than there, tumor size largerthan5cm and middle damage degrees of liver have close relationship with bloodglucose level.(4) Glucocorticoids application in chemotherapy is one of the reasonsleading to abnormal glucose metabolism.（5）Platinum combined with PTX or5-fuhad more effect on blood glucose level.