Significance of blood glucose levels and glucose metabolism-related genes on the prognosis of acute myeloid leukemia
[Objective]To investigate the correlation between blood glucose levels and the disease status,risk stratification and gene mutations of patients with acute myeloid leukemia (AML) and analyze the significance of glucose metabolism-related genes in AML prognosis.[Methods]This study included 280 newly diagnosed AML patients admitted to the Hematology Department of Xiangya Hospital from April 2017 to May 2021.Blood glucose level data before treatment were collected from patients in different disease stages (initial diagnosis,remission,and relapse),and t-tests or analysis of variance for inter-group comparisons was utilized.Cox analysis was used to screen glucose metabolism-related genes associated with AML prognosis,and followed by leveraging time receiver operating characteristic (ROC) curves for further selection of genes with excellent predictive performance.Based on prognostic gene expression levels,patients were divided into high-expression and low-expression groups.Subsequently,Kaplan-Meier survival curves were plotted to assess the prognostic value of those genes.[Results]The blood glucose levels in AML patients were notably higher in the newly diagnosed and relapsed groups compared with the remission group (P<0.05).Patients were classified into low,intermediate and high-risk group based on the 2022 version of the European LeukemiaNet (ELN) guidelines,and the blood glucose levels of high-risk patients were higher than those in the low and intermediate-risk groups (P=0.046).Furthermore,blood glucose levels were higher in NPM1-mutated group (P=0.035);however,there was no statistically significant difference of blood glucose levels among different age,FAB classification,cytogenetics,FLT3 mutation,and CEBPA mutation (P>0.05).Six glucose metabolism-related genes significantly associated with AML prognosis were identified using Cox regression analysis and time ROC curve (P<0.05).These genes included PLA2G4A,PTPN1,SORT1,CTH,AKAP9,and MLYCD,among which the high expression of the first three genes remarkably decreased overall survival rate in AML patients (P<0.05),while elevated expression of the latter three genes significantly improved patient overall survival rate (P<0.05).[Conclusion]The blood glucose levels were associated with the disease status,risk stratification and NPM1 mutation in AML patients.And the prognostic risk analysis based on glucose metabolism-related genes can predict the overall survival of AML patients.
万方数据
维普
