Metabolic syndrome predicts postoperative complications after gastrectomy in gastric cancer patients: Development of an individualized usable nomogram and rating model

Chen, Xiao; Zhang, Weiteng; Sun, Xia; Shi, Mingming; Xu, Liping; Cai, Yiqi; Chen, Wenjing; Mao, Chenchen; Shen, Xian

doi:10.1002/cam4.3352

Cited by 11 publications

(19 citation statements)

References 28 publications

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“…The presence of MetS increases the risk for postoperative complications, including prolonged hospital stay and risk for postsurgical complications (OR, 1.20 [95% CI, 1.03–1.09] and 1.22 [95% CI, 1.09–1.37] for patients with breast and prostate cancer with MetS undergoing tumor removal, respectively), blood transfusion, surgical site infection, and respiratory failure, across various surgical populations. 246,270–274…”

Section: Metabolic Syndromementioning

confidence: 99%

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

3,530

702

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BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year’s worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Section: Metabolic Syndromementioning

confidence: 99%

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

3,530

702

View full text Add to dashboard Cite

show abstract

“…Accordingly, a total of 1248 (18.8%) patients had MetS at baseline. The follow-up durations were within hospitalization for studies reported the outcome of postoperative complications only 13 17 , and varied from 35 to 75 months for studies reporting the outcomes of overall mortality and cancer recurrence. Multivariate models were applied to analyze the associations between MetS and clinical outcomes of patients with GC, and possible confounding factors such as age, sex, tumor characteristics, and other anticancer therapies etc.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, 549 articles were excluded since their titles and abstracts were not relevant to the meta-analysis, leaving 24 studies in total for the full-text review. Finally, after excluding 16 studies through full-text review, eight studies [13][14][15][16][17][18][19][20] were included. The reasons for the removing of the 16 studies are also presented in ▶ Fig.…”

Section: Studies Obtainedmentioning

confidence: 99%

“…As shown in ▶table 1, eight cohort studies, four retrospective [13][14][15]19] and four prospective [16][17][18]20], involving 6649 patients with GC, were included in the meta-analysis. All these studies were performed in China expect for one study, which was performed in Korea [14].…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…By inducing lowgrade systemic inflammation, MetS has been associated with the Original Article: Endocrine Care Metabolic Syndrome and Clinical Outcomes of Patients with Gastric Cancer: A Meta-Analysis pathogenesis of several cancers [11], including GC in women [12]. However, previous studies evaluating the influences of MetS on clinical outcomes in patients with GC showed inconsistent results [13][14][15][16][17][18][19][20]. Some studies suggested an adverse influence of MetS in patients with GC [13][14][15][16][17], while others did not [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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Metabolic Syndrome and Clinical Outcomes of Patients with Gastric Cancer: A Meta-Analysis

et al. 2023

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Metabolic syndrome (MetS) is suggested to participate in the pathogenesis and progress of some cancers via inducing low-grade systemic inflammation. However, the influence of MetS on patients with gastric cancer (GC) remains not fully determined. A systematic review and meta-analysis was therefore performed to evaluate the influence of MetS on clinical outcomes of patients with GC. A search of PubMed, Embase, Web of Science, Wanfang, and CNKI retrieved relevant cohort studies from the inception of the databases to October 11, 2022. We pooled the results using a random-effects model that incorporates heterogeneity. In the meta-analysis, 6649 patients with GC were included, and all of them received gastrectomy. A total of 1248 (18.8%) patients had MetS at baseline. Pooled results showed that MetS was associated with higher risks of postoperative complications [risk ratio (RR): 2.41, 95% confidence interval (CI): 1.85 to 3.14, p<0.001; I2=55%], overall mortality (RR: 1.73, 95% CI: 1.85 to 3.14, p<0.001; I2=77%), and recurrence of GC (RR: 2.00, 95% CI: 1.10 to 3.63, p=0.02; I2=39%). Subgroup analyses showed similar results in prospective and retrospective cohort studies and in studies with MetS diagnosed with the Chinese Diabetes Society criteria and the National Cholesterol Education Program Adult Treatment Panel III criteria (p for subgroup difference all>0.05). In patients with GC after gastrectomy, MetS may be a predictor of high incidence of postoperative complications, cancer recurrence, and overall mortality.

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Association of metabolic syndrome and frailty with postoperative complications in older gastric cancer patients: A body composition perspective

Jiang,

Ding,

Guo

et al. 2024

Cancer Medicine

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ObjectivesTo compare the characteristics of body compositions between metabolic syndrome (MetS) and frailty, and determine the independent and overlapping of MetS and frailty with postoperative complications among older patients with gastric cancer.DesignA prospectively observational study.Setting and ParticipantsTwo hundred and eighty six older patients from 60 to 80 years undergoing radical gastrectomy for the first time.MeasurementsMetS was diagnosed by the criteria from the 2020 edition of Chinese guideline for the prevention and treatment of type 2 diabetes mellitus, and frailty was defined by frailty phenotype. An InBody770 impedance analyzer was used to measure body compositions and with 10 fat‐ and muscle‐related indicators being included in this study. Based on the presence of frailty and MetS, patients were divided into the frailty group, MetS group, frailty+MetS group, and normal group, and the body compositions indicators of these groups were compared. Clavien–Dindo classification was used to grade the severity of postoperative complications. Univariate and multivariate regression models were performed to explore the independent and joint association of MetS and frailty with postoperative complications.ResultsThe incidence rate of MetS, frailty, and frailty+MetS being 20.3%, 15.7%, and 4.2% respectively. Compared with the normal group, both fat and muscle compositions were decreased significantly in the frailty group (p < 0.05), while the statistically significant difference of fat‐to‐muscle mass ratio (FMR) and skeletal muscle mass to visceral fat area ratio (SVR) were not observed (p > 0.05). In contrast, except SVR, the other indicators of the MetS group were higher than the normal group (p < 0.05). As to the frailty+MetS group, there was a significant increase in fat compositions and FMR, as well as a significant decline in SVR (p < 0.05), while the difference of muscle compositions was not statistically significant (p > 0.05). There was an association of frailty with postoperative total (OR = 3.068, 95% CI: 1.402–6.713) and severe (OR = 9.423, 95% CI: 2.725–32.589) complications, but no association was found of MetS alone. MetS coexisting with frailty was associated with the highest risk of both total (OR = 3.852, 95% CI: 1.020–14.539) and severe (OR = 12.096, 95% CI: 2.183–67.024) complications.ConclusionsBoth frailty and MetS coexisting with frailty had adverse effects on postoperative complications, which appeared greatly different characteristics in body compositions and therefore reinforced the importance of targeted nutritional or metabolic intervention. Although MetS alone were not significantly associated with postoperative complications, it is essential to focus on the causal relationship and development trend between MetS and frailty to prevent MetS from shifting into frailty, considering the highest risk in their coexistence state.

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Metabolic syndrome predicts postoperative complications after gastrectomy in gastric cancer patients: Development of an individualized usable nomogram and rating model

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 11 publications

References 28 publications

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Metabolic Syndrome and Clinical Outcomes of Patients with Gastric Cancer: A Meta-Analysis

Association of metabolic syndrome and frailty with postoperative complications in older gastric cancer patients: A body composition perspective

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