Systemic inflammation and insulin resistance-related indicator predicts poor outcome in patients with cancer cachexia
Abstract Background The C-reactive protein (CRP)-triglyceride-glucose (TyG) index (CTI), which is a measure representing the level of inflammation and insulin resistance (IR), is related to poor cancer prognosis; however, the CTI has not been validated in patients with cancer cachexia. Thus, this st...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
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| Series: | Cancer & Metabolism |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40170-024-00332-8 |
| _version_ | 1797276335819718656 |
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| author | Guo-Tian Ruan Li Deng Hai-Lun Xie Jin-Yu Shi Xiao-Yue Liu Xin Zheng Yue Chen Shi-Qi Lin He-Yang Zhang Chen-An Liu Yi-Zhong Ge Meng-Meng Song Chun-Lei Hu Xiao-Wei Zhang Ming Yang Wen Hu Ming-Hua Cong Li-Chen Zhu Kun-Hua Wang Han-Ping Shi |
| author_facet | Guo-Tian Ruan Li Deng Hai-Lun Xie Jin-Yu Shi Xiao-Yue Liu Xin Zheng Yue Chen Shi-Qi Lin He-Yang Zhang Chen-An Liu Yi-Zhong Ge Meng-Meng Song Chun-Lei Hu Xiao-Wei Zhang Ming Yang Wen Hu Ming-Hua Cong Li-Chen Zhu Kun-Hua Wang Han-Ping Shi |
| author_sort | Guo-Tian Ruan |
| collection | DOAJ |
| description | Abstract Background The C-reactive protein (CRP)-triglyceride-glucose (TyG) index (CTI), which is a measure representing the level of inflammation and insulin resistance (IR), is related to poor cancer prognosis; however, the CTI has not been validated in patients with cancer cachexia. Thus, this study aimed to explore the potential clinical value of the CTI in patients with cancer cachexia. Methods In this study, our prospective multicenter cohort included 1411 patients with cancer cachexia (mean age 59.45 ± 11.38, 63.3% male), which was a combined analysis of multiple cancer types. We randomly selected 30% of the patients for the internal test cohort (mean age 58.90 ± 11.22% 61.4% male). Additionally, we included 307 patients with cancer cachexia in the external validation cohort (mean age 61.16 ± 11, 58.5% male). Receiver operating characteristic (ROC) and calibration curves were performed to investigate the prognostic value of CTI. The prognostic value of the CTI was also investigated performing univariate and multivariate survival analyses. Results The survival curve indicated that the CTI showed a significant prognostic value in the total, internal, and external validation cohorts. Prognostic ROC curves and calibration curves revealed that the CTI showed good consistency in predicting the survival of patients with cancer cachexia. Multivariate survival analysis showed that an elevated CTI increased the risk of death by 22% (total cohort, 95% confidence interval [CI] = 1.13–1.33), 34% (internal test cohort, 95%CI = 1.11–1.62), and 35% (external validation cohort, 95%CI = 1.14–1.59) for each increase in the standard deviation of CTI. High CTI reliably predicted shorter survival (total cohort, hazard ratio [HR] = 1.45, 95%CI = 1.22–1.71; internal test cohort, HR = 1.62, 95%CI = 1.12–2.36; external validation cohort, HR = 1.61, 95%CI = 1.15–2.26). High CTI significantly predicted shorter survival in different tumor subgroups, such as esophageal [HR = 2.11, 95%CI = 1.05–4.21] and colorectal cancer [HR = 2.29, 95%CI = 1.42–3.71]. The mediating effects analysis found that the mediating proportions of PGSGA, ECOG PS, and EORTC QLQ-C30 on the direct effects of CTI were 21.72%, 19.63%, and 11.61%, respectively We found that there was a significant positive correlation between the CTI and 90-day [HR = 2.48, 95%CI = 1.52–4.14] and 180-day mortality [HR = 1.77,95%CI = 1.24–2.55] in patients with cancer cachexia. Conclusion The CTI can predict the short- and long-term survival of patients with cancer cachexia and provide a useful prognostic tool for clinical practice. |
| first_indexed | 2024-03-07T15:26:49Z |
| format | Article |
| id | doaj.art-780f5563c06f4918994c8d208aac1aab |
| institution | Directory Open Access Journal |
| issn | 2049-3002 |
| language | English |
| last_indexed | 2024-03-07T15:26:49Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer & Metabolism |
| spelling | doaj.art-780f5563c06f4918994c8d208aac1aab2024-03-05T16:39:21ZengBMCCancer & Metabolism2049-30022024-01-0112111710.1186/s40170-024-00332-8Systemic inflammation and insulin resistance-related indicator predicts poor outcome in patients with cancer cachexiaGuo-Tian Ruan0Li Deng1Hai-Lun Xie2Jin-Yu Shi3Xiao-Yue Liu4Xin Zheng5Yue Chen6Shi-Qi Lin7He-Yang Zhang8Chen-An Liu9Yi-Zhong Ge10Meng-Meng Song11Chun-Lei Hu12Xiao-Wei Zhang13Ming Yang14Wen Hu15Ming-Hua Cong16Li-Chen Zhu17Kun-Hua Wang18Han-Ping Shi19Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityClinical Nutrition Department, Sichuan University West China HospitalComprehensive Oncology Department, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Immunology, School of Preclinical Medicine, Guangxi Medical UniversityYunnan UniversityDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical UniversityAbstract Background The C-reactive protein (CRP)-triglyceride-glucose (TyG) index (CTI), which is a measure representing the level of inflammation and insulin resistance (IR), is related to poor cancer prognosis; however, the CTI has not been validated in patients with cancer cachexia. Thus, this study aimed to explore the potential clinical value of the CTI in patients with cancer cachexia. Methods In this study, our prospective multicenter cohort included 1411 patients with cancer cachexia (mean age 59.45 ± 11.38, 63.3% male), which was a combined analysis of multiple cancer types. We randomly selected 30% of the patients for the internal test cohort (mean age 58.90 ± 11.22% 61.4% male). Additionally, we included 307 patients with cancer cachexia in the external validation cohort (mean age 61.16 ± 11, 58.5% male). Receiver operating characteristic (ROC) and calibration curves were performed to investigate the prognostic value of CTI. The prognostic value of the CTI was also investigated performing univariate and multivariate survival analyses. Results The survival curve indicated that the CTI showed a significant prognostic value in the total, internal, and external validation cohorts. Prognostic ROC curves and calibration curves revealed that the CTI showed good consistency in predicting the survival of patients with cancer cachexia. Multivariate survival analysis showed that an elevated CTI increased the risk of death by 22% (total cohort, 95% confidence interval [CI] = 1.13–1.33), 34% (internal test cohort, 95%CI = 1.11–1.62), and 35% (external validation cohort, 95%CI = 1.14–1.59) for each increase in the standard deviation of CTI. High CTI reliably predicted shorter survival (total cohort, hazard ratio [HR] = 1.45, 95%CI = 1.22–1.71; internal test cohort, HR = 1.62, 95%CI = 1.12–2.36; external validation cohort, HR = 1.61, 95%CI = 1.15–2.26). High CTI significantly predicted shorter survival in different tumor subgroups, such as esophageal [HR = 2.11, 95%CI = 1.05–4.21] and colorectal cancer [HR = 2.29, 95%CI = 1.42–3.71]. The mediating effects analysis found that the mediating proportions of PGSGA, ECOG PS, and EORTC QLQ-C30 on the direct effects of CTI were 21.72%, 19.63%, and 11.61%, respectively We found that there was a significant positive correlation between the CTI and 90-day [HR = 2.48, 95%CI = 1.52–4.14] and 180-day mortality [HR = 1.77,95%CI = 1.24–2.55] in patients with cancer cachexia. Conclusion The CTI can predict the short- and long-term survival of patients with cancer cachexia and provide a useful prognostic tool for clinical practice.https://doi.org/10.1186/s40170-024-00332-8Systemic inflammationInsulin resistanceCTIOverall survival |
| spellingShingle | Guo-Tian Ruan Li Deng Hai-Lun Xie Jin-Yu Shi Xiao-Yue Liu Xin Zheng Yue Chen Shi-Qi Lin He-Yang Zhang Chen-An Liu Yi-Zhong Ge Meng-Meng Song Chun-Lei Hu Xiao-Wei Zhang Ming Yang Wen Hu Ming-Hua Cong Li-Chen Zhu Kun-Hua Wang Han-Ping Shi Systemic inflammation and insulin resistance-related indicator predicts poor outcome in patients with cancer cachexia Cancer & Metabolism Systemic inflammation Insulin resistance CTI Overall survival |
| title | Systemic inflammation and insulin resistance-related indicator predicts poor outcome in patients with cancer cachexia |
| title_full | Systemic inflammation and insulin resistance-related indicator predicts poor outcome in patients with cancer cachexia |
| title_fullStr | Systemic inflammation and insulin resistance-related indicator predicts poor outcome in patients with cancer cachexia |
| title_full_unstemmed | Systemic inflammation and insulin resistance-related indicator predicts poor outcome in patients with cancer cachexia |
| title_short | Systemic inflammation and insulin resistance-related indicator predicts poor outcome in patients with cancer cachexia |
| title_sort | systemic inflammation and insulin resistance related indicator predicts poor outcome in patients with cancer cachexia |
| topic | Systemic inflammation Insulin resistance CTI Overall survival |
| url | https://doi.org/10.1186/s40170-024-00332-8 |
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