| Objective: To describe the clinical features of patients with type 2 diabetes mellitus(T2DM)in patients with Malignant Tumor in Shihezi area,and to explore the influencing factors of malignant tumor combined with T2 DM.And then to provide the basis for the further clinical diagnosis and treatment of malignant tumor complicated with T2 DM.Methods: Patients with malignant tumors and healthy controls were enrolled in the first affiliated Hospital of Medical College of Shihezi University from November 2016 to April 2018.According to the results of OGTT or previous history of T2 DM,three groups were divided as healthy control group,simple malignant tumor group,malignant tumor with T2 DM group.Then,the general data,such as age,sex,height,weight,malignant tumor type,history of diabetes,hypertension,coronary heart disease and other history of general clinical baseline data.,were recorded.2.Related clinical indexes were collected,such as alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(T-Bil),direct bilirubin(D-Bil),indirect bilirubin(I-Bil)and other liver function indexes;Urea nitrogen(BUN),creatinine(CR),uric acid(UA)and other renal function indexes;total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C)and other lipid metabolism indexes;fasting plasma glucose(FPG),fructosamine(FMN)and other glucose metabolism indexes;alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),glycosyl antigen 19-9(CA19-9)and other tumor markers.3.SPSS 20.0 software was used to analyze the data,ANOVA was used to analyze multi-group measurement data when baseline data were homogenous,and covariance analysis was used to compare the multi-group measurement data when baseline data were not uniform.Logistic regression analysis was used for influencing factors.Hypothesizing the test level was ?=0.05,the difference was statistically significant at P < 0.05 by bilateral test.Results: 1.Classification of malignant tumors: A total of 1332 patients with simple malignant tumors were included in this study,38.51%(513 cases)of digestive system malignant tumors,25.30%(337 cases)of gynecological system tumors,19.37%(258 cases)of respiratory malignant tumors,and 8.71%(116 cases)of urological malignant tumors,6.23%(88 cases)of endocrine system malignancies,respectively.While 315 patients with malignant tumors and T2 DM were included in the study,digestive system malignant tumors accounting for 42.54%(134 cases),gynecological system tumors accounting for 20.95%(66 cases),respiratory malignant tumors accounting for 20.32%(64 cases),urinary system malignant tumors accounting for 10.48%(33 cases),endocrine system malignant tumors accounting for 4.44%(14 cases).2.Comparison of general clinical data among there groups: The mean age was 52.96 ±10.98 years in the control group(310 cases,male to female ratio was 138/172);the mean age was 59.62±12.89 years in the malignant tumor group(1332 cases,male to female ratio was 629/703);the mean age was 65.09±11.32 years in the malignant tumor with T2 DM group(315 cases,male to female ratio was 151/164).There was no significant difference in sex ratio among the three groups.Compared with the healthy control group,the age of simple malignant tumor group and malignant tumor complicated with T2 DM group was significantly higher(P< 0.05).There was statistical difference in age among the three groups.The difference was significant(P< 0.05).Compared with the healthy control group,the age in malignant tumor group and malignant tumor with T2 DM group increased(P<0.05),and the age of the three groups was statistically different(P< 0.05).3.Comparison of glucose and lipid metabolism indicators by covariance analysis showed that compared with healthy control group,TG(1.38 vs 1.36,P=0.002),TC(4.44 vs 4.15,P < 0.001)and LDL-C(2.60 vs 2.44,P=0.043)was lower in malignant tumor group;compared with malignant tumor group,TG(1.16 vs 1.36,P < 0.001)and FMN(187.22 vs 223.39,P<0.001)was higher in malignant tumor with T2 DM group.compared with healthy control group,FPG(4.83 vs 7.69,P<0.001)was higher in malignant tumor with T2 DM group;HDL-C(1.19 vs 1.10 vs 1.05,P<0.05)were all lower both in malignant tumor group and malignant tumor with T2 DM group.4.Comparison of liver and renal function indicators by covariance analysis showed that compared with malignant tumor group,TP(65.38 vs 66.49,P= 0.004)was higher in malignant tumor with T2 DM group;compared with healthy control group,ALT(19.90 vs 25.95,P < 0.05)was higher in malignant tumor with T2 DM group,while ALB(41.67 vs 39.33 vs 39.17,P < 0.001)was lower and AST(19.08 vs 24.74 vs 26.20,P < 0.05)was higher in malignant tumor group and malignant tumor with T2 DM group;GLB and GGT all increased in malignant tumor with T2 DM group.There were no significant difference in T-Bil?D-Bil?I-Bil?TBA among the three groups(P > 0.05).5.Comparison of tumor markers by covariance analysis showed that compared with healthy control group,AFP(3.39 vs 34.29 vs 40.91,P < 0.05)and CA19-9(10.30 vs 50.73 vs 63.46,P < 0.05)were all higher in malignant tumor group and malignant tumor with T2 DM group;CEA(1.92 vs 38.69,P < 0.05)and CA12-5(14.06 vs 103.52,P < 0.05)in malignant tumor with T2 DM group were higher than that in healthy control group.Compared with malignant tumor group,CEA(17.00 vs 38.69,P < 0.05)in malignant tumor with T2 DM group was higher.But there was no significant difference in CA15-3 and CA72-4 among the three groups(P > 0.05).6.Univariate multi-class logistic regression analysis of simple malignant tumors and malignant tumors with T2 DM showed that Age and FPG were risk factors for simple malignant tumor(OR = 1.046,1.326),while HDL-C,TG,TC,LDL-C were protective factors for simple malignant tumor respectively(OR = 0.367,0.788,0.766,0744).Age and FPG were also risk factors for malignant tumors with T2DM(OR = 1.083,2.529),while HDL-C and TC were protective factors for malignant tumors with T2DM(OR= 0.172,0.836).7.Multivariate multi-class logistic regression analysis of simple malignant tumors and malignant tumors with T2 DM showed that Age and FPG were risk factors for simple malignant tumor,and HDL-C was a protective factor for simple malignant tumor.Age and FPG were also risk factors for malignant tumors with T2 DM,and HDL-C was also a protective factor for malignant tumors with T2 DM.Conclusions: 1.Malignant tumors complicated with T2 DM had a high incidence of malignant tumors of digestive system,mainly colorectal malignant tumors.2.Age,FPG were the risk factors of malignant tumor complicated with T2 DM,3.HDL-C was the protective factor of malignant tumor complicated with T2 DM.4.With the increase of age,the patients with simple malignant tumor and malignant tumor with T2DM should not only screen the oncology indexes,but also screen the level of FPG and HDL-C,and shoula be timely diagnosed and treated in time,so as to lay the foundation for the early prevention and treatment of the diseases. |
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