Linkage of blood glucose, insulin and insulin resistance with excessive body weight in patients with abdominal malignancies

Background. There is evidence that different types of malignancies may have associations with diabetes mellitus (DM) and changes in carbohydrates metabolism. Other metabolic disorders like obesity may further influence management and patients’ follow-up. There are multiple connections between both metabolism disorders and abdominal malignancies (AM). They may result from slightly different mechanisms with up to 80 % of patients with pancreatic cancer had DM. The purpose was to study the clinical and pathogenetic implications of the glucose metabolism in patients with abdominal malignancies and excessive body weight. Materials and methods. This cohort-based observational study involves a total of 151 patients with AM divided into study (n = 121, body mass index (BMI) ≥ 30 kg/m2) and control (n = 30, BMI ≤ 29 kg/m2) groups. The diagnosis, staging, prevalence of the process, and concomitant pathology, anthropometric and statistical parameters were analyzed, and carbohydrate metabolism indicators such as blood glucose, insulin and HOMA-IR were assessed. Results. The presence of AM did not significantly influence the blood glucose concentration. The mean value of glucose in study group in patients with excessive body weight was 1.46 times (P = 0.014) higher compared to control group with BMI ≤ 29 kg/m2 depicting present changes in carbohydrates metabolism in these patients. While insulin did not differ between groups, HOMA-IR value was 1.57 times (P = 0.023) higher in study group patients. Conclusions. Changes of carbohydrate metabolism mark the difference between obese and non-obese patients with abdominal malignancies and may be considered an important clinical factor in potentially aggravating the overall condition of the patients and increasing the risk of postoperative complications and treatment failure. Therefore, it is plausible to consider consultation of the specialized endocrinologist in obese AM patients or the routine inclusion of such specialist into the general cancer team.