| Background:Diabetes mellitus and malignant tumor are two common chronic diseases,which seriously affect the quality of life and life span of patients.Epidemiological data show that the incidence of diabetes and malignant tumors is gradually increasing.Studies have shown that diabetes is closely related to malignant tumors,and diabetes may affect the occurrence of malignant tumors and the prognosis of patients.Objective:To explore the clinical characteristics of patients with type 2 diabetes associated with malignant tumors,and to analyze the possible risk factors for the occurrence of malignant tumors in patients with type 2 diabetes,so as to provide a clinical basis for the screening of malignant tumors in patients with type 2 diabetes.Methods:A total of 8,473 inpatients with type 2 diabetes mellitus in the Department of Enendocrinology and Metabolism of the First Hospital of Jilin University from May2015 to May 2020 were selected as the research subjects,and divided into two groups according to whether they were associated with malignant tumor or not: diabetes group and diabetes associated with malignant tumor group.Clinical data were collected to evaluate the clinical characteristics of patients with type 2 diabetes with malignant tumor,and the risk factors were analyzed statistically.Results:The detection rate of malignant tumors in patients with type 1 and type 2diabetes was 4.8%(404/8473),and the top five patients were colorectal cancer(76/404),lung cancer(62/404),liver cancer(42/404),gastric cancer(41/404)and breast cancer(32/404).2.The risk of malignant tumor in type 2 diabetic patients with BMI between 24 and 28kg/m2 was 4.8 times higher than that in type 2 diabetic patients with BMI ≤24kg/ M22(OR=4.8,95%CI 3.31-6.96,P < 0.001);Patients with BMI between 28 and32kg/m2 had a 7.8-fold higher risk of developing malignant tumor than those with BMI ≤24 kg/ M22(OR=7.78,95%CI 5.30-11.43,P < 0.001).Patients with type 2diabetes with a BMI of 32 kg/m2 were 8.9 times more likely to develop malignant tumors than those with a BMI of less than OR equal to 24 kg/ M22(OR=8.89,95%CI5.49-14.39,P < 0.001).3.Patients with type 2 diabetes with Hb A1 c between 6.5-8.0% had a 4.6 times higher risk of developing malignant tumors than those with Hb A1 c ≤6.5%(OR=4.60,95%CI 2.30-9.21,P < 0.001);Patients with type 2 diabetes with Hb A1 c between8.0-9.5% had a 10.5 times higher risk of developing malignant tumors than those with type 2 diabetes with Hb A1 c ≤6.5%.(OR=10.47,95%CI 5.32-20.62,P <0.001);Patients with type 2 diabetes who had Hb B0 A1 C at 9.5% were 9.0 times more likely to develop malignancy than patients with type 2 diabetes who had Hb B0 A1 C at OR below 6.5%(OR=8.98,95%CI 4.55-17.72,P < 0.001).4.The risk of malignant tumor in T2 DM patients with a course of diabetes between 60 and 120 months was 3.3 times higher than that in T2 DM patients with a course of diabetes ≤60 months(OR=3.29,95%CI 2.18-4.97,P < 0.001).Patients with diabetes course between 120 and 180 months had a 12.0 fold higher risk of developing malignant tumor than those with diabetes course ≤60 months(OR=11.96,95%CI 8.26-17.31,P < 0.001).The risk of malignancy in patients with type 2 diabetes with a course of > of 180 months was 10.1 times that in patients with type 2 diabetes with a course of diabetes ≤60 months(OR=10.13,95%CI 6.95-14.77,P < 0.001).5.The patients in the two groups who were treated with single-drug hypoglycemic therapy were analyzed,and the indicators with statistical significance were:Biguanidine(OR=0.19,95%CI 0.11-0.33),α-glycosidase inhibitors(OR=0.06,95%CI 0.02-0.26),DPP-4 inhibitors(OR=0.05,95%CI 0.01-0.33),Insulin(OR=1.74,95%CI 1.24-2.43).6.The general data and biochemical indicators of the two groups of patients were included in the logistic regression equation,and the indicators with statistical significance were:Age(OR=1.07,95%CI 1.06-1.08),body mass index(OR=1.27,95%CI 1.22-1.31),course of diabetes(OR=1.07,95%CI 1.05-1.08),history of coronary heart disease(OR=1.82,95%CI 1.38-2.41),smoking history(OR=1.36,95%CI 1.03-1.80),drinking history(OR=1.65,95%CI 1.22-2.23),glycated hemoglobin(OR=1.18,95%CI 1.12-1.25),triglycerides(OR=1.23,95%CI 1.17-1.31),high-density lipoprotein cholesterol(OR=2.94,95%CI 2.08-4.14),diabetic peripheral neuropathy(OR=1.32,95%CI 1.02-1.71),diabetic retinopathy(OR=1.61,95%CI1.25-2.07).Conclusion:1.The top 5 malignant tumor detection rates in type 2 diabetes patients were colorectal cancer,lung cancer,liver cancer,gastric cancer and breast cancer,respectively.2.With the increase of body mass index,the risk of malignant tumor in patients with type 2 diabetes was increased;When Hb A1 c was more than 8% and the duration of diabetes was more than 120 months,the risk of malignant tumor was significantly increased in patients with type 2 diabetes.3.Metformin treatment can reduce the risk of malignant tumors in patients with type 2 diabetes,while insulin treatment can increase the risk of malignant tumors in patients with type 2 diabetes;4.Advanced age,obesity,history of coronary heart disease,smoking history,drinking history,poor blood glucose control,increased course of diabetes,hypertriglyceridemia,high-density lipoprotein cholesterolemia,combined with diabetic peripheral neuropathy and diabetic retinopathy are the risk factors for malignant tumor in type 2 diabetes patients. |
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