Influencing factors of secondary diabetes mellitus after chemotherapy for hematologic tumors
Objective To investigate the influencing factors of secondary diabetes mellitus after chemotherapy for hematologic tumors. Methods The medical records of 396 patients with hematologic tumors admitted to Jinhua People's Hospital from January 2018 to January 2024 were retrospectively analyzed. According to whether patients developed secondary diabetes mellitus during chemotherapy,they were divided into secondary diabetes mellitus group (n=127) and non-diabetes mellitus group (n=269). Transcriptome sequencing was used to explore the different signaling pathways between two groups. Multivariate Logistic regression analysis was used to screen the influencing factors of secondary diabetes mellitus after chemotherapy,and the prediction model of secondary diabetes mellitus after hematologic tumor chemotherapy was constructed. Results The common differential genes in bone marrow samples of two groups were mainly concentrated in vascular endothelial function regulation and vascular homeostasis pathway. There were significant differences in age,body mass index (BMI) and family history of diabetes mellitus,hypertension and hyperlipidemia,dexamethasone on conversion cumulative quantity,endothelin-1 (ET-1),vascular cell adhesion molecule 1 (VCAM-1),endothelial nitric oxide synthase (eNOS) between two groups (P<0.05). Multivariate Logistic regression analysis showed that age,BMI,history of hyperlipidemia,dexamethasone on conversion cumulative quantity,ET-1,VCAM-1 and eNOS were independent influencing factors for secondary diabetes mellitus in patients with hematologic tumors after chemotherapy (P<0.05). The area under the curve of predictive model was 0.844 (95％CI:0.806-0.883,P<0.001),indicating that the predictive ability of the model was good. Conclusion Age,BMI,combined hyperlipidemia,dexamethasone on conversion cumulative quantity,ET-1,VCAM-1 and eNOS are all independent influencing factors for secondary diabetes mellitus in patients with hematologic tumors after chemotherapy,and the prediction model can be used as a tool for early clinical screening.
Hematologic tumorsChemotherapySecondary diabetes mellitusInfluencing factorPredictive model
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