Glucose and lipid metabolism in patients with advanced pancreatic cancer receiving palliative chemotherapy.

BACKGROUND

The role of diabetes mellitus (DM) in the pathogenesis of pancreatic cancer (PC) and its prognostic role on patients with advanced disease remain undefined.

METHODS

Within a prospective single-center pilot study, 30 consecutive patients with advanced PC underwent metabolic profiling for glucose (fasting glucose level, oral glucose tolerance test (oGTT), serum insulin levels) and lipid metabolism (cholesterol, triglycerides, lipoprotein a) at the initiation of and two months after chemotherapy. Subgroups (DM vs. non-DM) were analyzed with regard to metabolic and outcome parameters.

RESULTS

Sixteen patients (53%) had DM, in seven of whom DM was newly-diagnosed by an oGTT. Patients in the DM subgroup had a higher prevalence of hypertension (p=0.05) and a higher BMI (p=0.01), but with no significant differences in pre-treatment cholesterol (p=0.55) and triglyceride levels (p=0.37). Regarding baseline oncological parameters, patients with DM more often had a reduced performance status (p=0.06), and were more likely to present with metastatic disease (p=0.09). The median overall survival was 3.9 months in the DM group and 8.3 months in the non-DM group (hazard ratio=0.67, 95% confidence interval=0.31-1.45, p=0.31), respectively.

CONCLUSIONS

The incidence of DM is high in patients with PC and the lipid profile associated with DM may be different from that of patients with metabolic syndromes. The role of DM as a negative prognostic factor in advanced PC remains to be determined.