Mediating effect of blood glucose in the association between myosteatosis and complications in non-diabetic postoperative gastric cancer patients on supplemental parenteral nutrition
10.3760/cma.j.cn115822-20211116-00222
- VernacularTitle:非糖尿病胃癌患者术后补充性肠外营养期间血糖在骨骼肌脂肪浸润与并发症关联中的中介效应
- Author:
Ning LAN
1
;
Yujie ZHOU
;
Fuzhi JIAO
;
Yining ZHAO
;
Fei KONG
;
Yanting LI
;
Quanlin GUAN
;
Wenzhen YUAN
Author Information
1. 兰州大学第一临床医学院 730000
- Keywords:
Radical gastrectomy;
Supplemental parenteral nutrition;
Blood glucose;
Myosteatosis;
Complication;
Mediation effect
- From:
Chinese Journal of Clinical Nutrition
2022;30(1):19-26
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of myosteatosis and blood glucose (BG) on postoperative complications in non-diabetic gastric cancer patients receiving supplemental parenteral nutrition (SPN) after gastrectomy.Methods:Patients who underwent radical gastrectomy between March 2017 and June 2021 in the Department of Surgical Oncology, the First Hospital of Lanzhou University were included in this study. Various preoperative inflammatory and nutritional indicators, including skeletal muscle metrics at the third lumbar level on CT, were collected retrospectively. Postoperative BG within 3 days and complications within 30 days were monitored. Patients were divided into two groups according to the presence or absence of myosteatosis (assessed via skeletal muscle density [SMD]) and the differences in postoperative BG and complication incidence were compared. Mediation model was used to analyze the mediating effect of BG in the association between SMD and postoperative complications.Results:A total of 357 patients were included in the study. Compared with the 299(83.8%) patients without myosteatosis , the incidence of hyperglycemia, mean BG, maximal BG, and BG fluctuation while on SPN in the 58(16.2%) patients with myosteatosis were higher, and the comprehensive complication index (CCI) and the incidence of complication were higher ( P<0.05). More importantly, BG showed the mediation effect of -0.0892 in the effect of SMD on CCI ( P<0.05), with the effect size of 19.3％. Conclusion:Myosteatosis and postoperative hyperglycemia are associated with higher incidence of complications, and BG plays an intermediary role in the association between myosteatosis and CCI.
