Relationship between type 2 diabetes mellitus and markers of cutaneous melanoma aggressiveness: an observational multicentric study in 443 patients with melanoma
Relationship between type 2 diabetes mellitus and markers of cutaneous melanoma aggressiveness: an observational multicentric study in 443 patients with melanoma
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DOI：
10.1111/bjd.19813
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发表时间：
2021-03-18
影响因子：
10.3
通讯作者：
Gozal, D.
中科院分区：
文献类型：
--
作者：
Nagore, E.;Martinez-Garcia, M. A.;Gozal, D.
一些研究表明2型糖尿病（T2 DM）与黑色素瘤发病率增加之间存在关系。目前正在努力确定与黑色素瘤侵袭性增加相关的可预防和可治疗因素，但迄今为止还没有研究探讨T2 DM与诊断时皮肤黑色素瘤侵袭性之间的关系。目的探索T2 DM、血液控制和二甲双胍治疗与皮肤黑色素瘤侵袭性的关系。对443例皮肤黑色素瘤患者进行的多中心横断面研究。在诊断时，所有患者都完成了标准化的方案，并提取了空腹血液样本，以分析他们的葡萄糖水平，糖化血红蛋白浓度和全身炎症标志物。结果本组患者平均年龄55岁，中心点98岁（15中心点3岁），男性占50中心点6%。中位Breslow厚度为0中心点85 mm。（10个中心点8%）患者被诊断为T2 DM，并且该发现与Breslow厚度> 2 mm相关[比值比（OR）2中心点6，95%置信区间（CI）1中心点4-4中心点9; P = 0中心点004）]且> 4 mm（OR 3中心点6，95% CI 1中心点7-7中心点9; P = 0中心点001），TMR > 5/mm（2）（OR 4中心点5，95% CI 1中心点4-13中心点7; P = 0中心点0.09），SLN受累（OR 2中心点3，95% CI 1-5中心点7; P = 0中心点038）和肿瘤分期III-IV（对比I-II）（OR 3中心点4，95%CI 1中心点6-7中心点4; P = 0中心点002），校正年龄、性别、肥胖、饮酒和吸烟习惯后。糖化血红蛋白水平，二甲双胍治疗和黑色素瘤aggressiveness.Conclusions之间没有显着的关联出现T2 DM，而不是血糖控制和二甲双胍治疗，与增加皮肤黑色素瘤的侵略性在诊断。
Background Some studies have suggested a relationship between type 2 diabetes mellitus (T2DM) and increased incidence of melanoma. Efforts are under way to identify preventable and treatable factors associated with greater melanoma aggressiveness, but no studies to date have examined the relationship between T2DM and the aggressiveness of cutaneous melanoma at diagnosis.Objectives To explore potential associations between T2DM, glycaemic control and metformin treatment and the aggressiveness of cutaneous melanoma.Methods We conducted a cross-sectional multicentric study in 443 patients diagnosed with cutaneous melanoma. At diagnosis, all patients completed a standardized protocol, and a fasting blood sample was extracted to analyse their glucose levels, glycated haemoglobin concentration and markers of systemic inflammation. Melanoma characteristics and aggressiveness factors [Breslow thickness, ulceration, tumour mitotic rate (TMR), sentinel lymph node (SLN) involvement and tumour stage] were also recorded.Results The mean (SD) age of the patients was 55 center dot 98 (15 center dot 3) years and 50 center dot 6% were male. The median Breslow thickness was 0 center dot 85 mm. In total, 48 (10 center dot 8%) patients were diagnosed with T2DM and this finding was associated with a Breslow thickness > 2 mm [odds ratio (OR) 2 center dot 6, 95% confidence interval (CI) 1 center dot 4-4 center dot 9; P = 0 center dot 004)] and > 4 mm (OR 3 center dot 6, 95% CI 1 center dot 7-7 center dot 9; P = 0 center dot 001), TMR > 5 per mm(2) (OR 4 center dot 5, 95% CI 1 center dot 4-13 center dot 7; P = 0 center dot 009), SLN involvement (OR 2 center dot 3, 95% CI 1-5 center dot 7; P = 0 center dot 038) and tumour stages III-IV (vs. I-II) (OR 3 center dot 4, 95% CI 1 center dot 6-7 center dot 4; P = 0 center dot 002), after adjusting for age, sex, obesity, alcohol intake and smoking habits. No significant associations emerged between glycated haemoglobin levels, metformin treatment and melanoma aggressiveness.Conclusions T2DM, rather than glycaemic control and metformin treatment, is associated with increased cutaneous melanoma aggressiveness at diagnosis.