Associations between Systemic Immune-Inflammation Index and Diabetes Mellitus Secondary to Pancreatic Ductal Adenocarcinoma

Background: There is a high prevalence of diabetes mellitus (DM) in patients with pancreatic ductal adenocarcinoma (PDAC). An inflammatory response is considered as a potential mechanism involved in the process. The systemic immune-inflammation (SII) index is an integrated and novel inflammatory ind...

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Main Authors: Guanhua Chen, Chunlu Tan, Xubao Liu, Xing Wang, Qingquan Tan, Yonghua Chen
Format: Article
Language:English
Published: MDPI AG 2023-01-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/12/3/756
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author Guanhua Chen
Chunlu Tan
Xubao Liu
Xing Wang
Qingquan Tan
Yonghua Chen
author_facet Guanhua Chen
Chunlu Tan
Xubao Liu
Xing Wang
Qingquan Tan
Yonghua Chen
author_sort Guanhua Chen
collection DOAJ
description Background: There is a high prevalence of diabetes mellitus (DM) in patients with pancreatic ductal adenocarcinoma (PDAC). An inflammatory response is considered as a potential mechanism involved in the process. The systemic immune-inflammation (SII) index is an integrated and novel inflammatory indicator developed in recent years. The purpose of this study was to determine the relationship between the SII and DM secondary to PDAC. Method: Patients with a confirmed diagnosis of PDAC were analyzed in this cross-sectional study. Anthropometric measures, glucose-related data (including fasting glucose, 2 h OGTT, glycated hemoglobin, fasting insulin, and fasting c-peptide), tumor characteristics (tumor volumes, location and stages), and the periphery blood inflammatory index (white blood cell count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and SII) were recorded. The inflammation index was analyzed for its association with glucose-related parameters. Multivariable logistic regression analysis was used to analyze the association between SII levels and DM secondary to PDAC. Results: Blood cell results showed that the white blood cell count, neutrophils, lymphocytes, monocytes, platelets, the neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were higher in patients with diabetes. It was worth noting that SII significantly increased in patients with diabetes secondary to PDAC (4.41 vs. 3.19, <i>p</i> < 0.0001). Multivariable logistic regression analysis showed that SII (OR: 2.024, 95%CI: 1.297, 3.157, <i>p</i> = 0.002) and age (OR: 1.043, 95%CI: 1.01, 1.077, <i>p</i> = 0.011) were the risk factors for DM secondary to PDAC after adjusting for covariates. According to Spearmen correlation analysis, SII was positively correlated with fasting glucose (r = 0.345, <i>p</i> < 0.0001), 2 h OGTT (r = 0.383, <i>p</i> < 0.0001), HbA1c (r = 0.211, <i>p</i> = 0.005), fasting insulin (r = 0.435, <i>p</i> < 0.0001), fasting C-peptide (r = 0.420, <i>p</i> < 0.0001), and HOMA2-IR (r = 0.491, <i>p</i> < 0.0001). Conclusions: In conclusion, SII is significantly increased among patients with DM secondary to PDAC and is associated with the DM in patients with PDAC (OR: 2.382, 95% CI: 1.157, 4.903, <i>p</i> = 0.019). Additionally, SII is significantly correlated with insulin resistance. We are the first to investigate the relationship between SII and diabetes secondary to PDAC and further confirm the role of an inflammatory response in this process. More studies need to be designed to clarify how inflammatory responses participate.
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spelling doaj.art-705cd09711984e9eb1a258ee75f2ae2f2023-11-16T17:06:45ZengMDPI AGJournal of Clinical Medicine2077-03832023-01-0112375610.3390/jcm12030756Associations between Systemic Immune-Inflammation Index and Diabetes Mellitus Secondary to Pancreatic Ductal AdenocarcinomaGuanhua Chen0Chunlu Tan1Xubao Liu2Xing Wang3Qingquan Tan4Yonghua Chen5Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, ChinaDepartment of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, ChinaDepartment of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, ChinaDepartment of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, ChinaDepartment of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, ChinaDepartment of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, ChinaBackground: There is a high prevalence of diabetes mellitus (DM) in patients with pancreatic ductal adenocarcinoma (PDAC). An inflammatory response is considered as a potential mechanism involved in the process. The systemic immune-inflammation (SII) index is an integrated and novel inflammatory indicator developed in recent years. The purpose of this study was to determine the relationship between the SII and DM secondary to PDAC. Method: Patients with a confirmed diagnosis of PDAC were analyzed in this cross-sectional study. Anthropometric measures, glucose-related data (including fasting glucose, 2 h OGTT, glycated hemoglobin, fasting insulin, and fasting c-peptide), tumor characteristics (tumor volumes, location and stages), and the periphery blood inflammatory index (white blood cell count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and SII) were recorded. The inflammation index was analyzed for its association with glucose-related parameters. Multivariable logistic regression analysis was used to analyze the association between SII levels and DM secondary to PDAC. Results: Blood cell results showed that the white blood cell count, neutrophils, lymphocytes, monocytes, platelets, the neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were higher in patients with diabetes. It was worth noting that SII significantly increased in patients with diabetes secondary to PDAC (4.41 vs. 3.19, <i>p</i> < 0.0001). Multivariable logistic regression analysis showed that SII (OR: 2.024, 95%CI: 1.297, 3.157, <i>p</i> = 0.002) and age (OR: 1.043, 95%CI: 1.01, 1.077, <i>p</i> = 0.011) were the risk factors for DM secondary to PDAC after adjusting for covariates. According to Spearmen correlation analysis, SII was positively correlated with fasting glucose (r = 0.345, <i>p</i> < 0.0001), 2 h OGTT (r = 0.383, <i>p</i> < 0.0001), HbA1c (r = 0.211, <i>p</i> = 0.005), fasting insulin (r = 0.435, <i>p</i> < 0.0001), fasting C-peptide (r = 0.420, <i>p</i> < 0.0001), and HOMA2-IR (r = 0.491, <i>p</i> < 0.0001). Conclusions: In conclusion, SII is significantly increased among patients with DM secondary to PDAC and is associated with the DM in patients with PDAC (OR: 2.382, 95% CI: 1.157, 4.903, <i>p</i> = 0.019). Additionally, SII is significantly correlated with insulin resistance. We are the first to investigate the relationship between SII and diabetes secondary to PDAC and further confirm the role of an inflammatory response in this process. More studies need to be designed to clarify how inflammatory responses participate.https://www.mdpi.com/2077-0383/12/3/756pancreatic ductal adenocarcinomadiabetes mellitusinflammationsystemic immune-inflammation index
spellingShingle Guanhua Chen
Chunlu Tan
Xubao Liu
Xing Wang
Qingquan Tan
Yonghua Chen
Associations between Systemic Immune-Inflammation Index and Diabetes Mellitus Secondary to Pancreatic Ductal Adenocarcinoma
Journal of Clinical Medicine
pancreatic ductal adenocarcinoma
diabetes mellitus
inflammation
systemic immune-inflammation index
title Associations between Systemic Immune-Inflammation Index and Diabetes Mellitus Secondary to Pancreatic Ductal Adenocarcinoma
title_full Associations between Systemic Immune-Inflammation Index and Diabetes Mellitus Secondary to Pancreatic Ductal Adenocarcinoma
title_fullStr Associations between Systemic Immune-Inflammation Index and Diabetes Mellitus Secondary to Pancreatic Ductal Adenocarcinoma
title_full_unstemmed Associations between Systemic Immune-Inflammation Index and Diabetes Mellitus Secondary to Pancreatic Ductal Adenocarcinoma
title_short Associations between Systemic Immune-Inflammation Index and Diabetes Mellitus Secondary to Pancreatic Ductal Adenocarcinoma
title_sort associations between systemic immune inflammation index and diabetes mellitus secondary to pancreatic ductal adenocarcinoma
topic pancreatic ductal adenocarcinoma
diabetes mellitus
inflammation
systemic immune-inflammation index
url https://www.mdpi.com/2077-0383/12/3/756
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