Association of systemic inflammation markers in cancer mortality with diabetes: evidence from National Health and Nutrition Examination Survey

Acta Diabetol. 2024 Nov;61(11):1403-1412. doi: 10.1007/s00592-024-02301-5. Epub 2024 May 27.

Abstract

Aims: Inflammation plays a crucial role in the interconnection between diabetes and cancer. Our study seeks to investigate the predictive value of inflammatory indices concerning overall survival (OS) among diabetic cancer patients.

Methods: We analyzed data from the National Health and Nutrition Examination Survey between 1999 and 2020. Using four immune-related markers, we employed the log-rank method, multivariate Cox regression, and subgroup analysis to explore the predictive capacity of these markers for OS among adult individuals with diabetes and cancer.

Results: Our study identified four systemic immune-inflammatory indices that demonstrated significant predictive potential for OS among diabetic cancer patients, namely systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio (all p values < 0.05). Notably, these inflammatory biomarkers still maintain their predictive value after adjusting potential confounding factors. The analysis using restrictive cubic splines revealed significant non-linear relationships between inflammatory biomarkers and OS.

Conclusion: The findings presented in this study underscore the potential of inflammatory markers as prognostic indicators and their crucial role in enhancing risk assessment for diabetic patients with cancer.

Keywords: Cancer; Diabetes; Inflammation; Prediction.

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / mortality
  • Female
  • Humans
  • Inflammation* / blood
  • Male
  • Middle Aged
  • Neoplasms* / blood
  • Neoplasms* / mortality
  • Nutrition Surveys*
  • Prognosis

Substances

  • Biomarkers