Risk factors for glucocorticoid induced-diabetes mellitus in patients who received R-CHOP
演題番号 : PS-1-190
李 碩瑛 （Suk-Young Lee):1、栗田 尚樹 （Naoki Kurita):1、横山 泰久 （Yasuhisa Yokoyama):1、関 正則 （Masanori Seki):1、長谷川 雄一 （Yuichi Hasegawa):1、千葉 滋 （Shigeru Chiba):1
1:Department of Hematology, University of Tsukuba, Tsukuba, Ibaraki, Japan
< Background > Glucocorticoid induced-diabetes mellitus (GDM) is one of major problems during treatment of lymphoma, and we evaluated risk factors for development of GDM in patients who received R-CHOP. 46 patients who recived R-CHOP from November 2006 to June 2012 were analyzed. Diagnosis of DM was made by fasting plasma glucose ≧ 126 mg/dL or a random plasma glucose ≧ 200 mg/dL with classic symptoms of hyperglycemia. Metabolic syndrome was defined by body mass index > 30 kg/m2 and any two of followings: 1) triglycerides > 150 mg/dL; 2) HDL cholesterol < 40 mg/dL in males, < 50 mg/dL in females, or specific treatment for lipid abnormality; 3) systolic blood pressure (SBP) ≧ 130 or diastolic BP (DBP) ≧ 85 mm Hg. Hemoglobin A1c (HbA1c) are expressed in HbA1c, NGSP. Univariate analysis was performed by chi-square test, and linear logistic regression analysis was used for multivariate analysis. < Results> Total number of patients diagnosed as GDM during R-CHOP was 14 (30.4%). Significant pre-chemotherapy factors associated with GDM were HbA1c > 5.8%, metabolic syndrome, and history of hypertension (HTN) or elevated BP (SBP ≧ 130 mmHg, DBP ≧ 85 mmHg) at start of R-CHOP with univariate analysis (p < .05). With multivariate analysis, HbA1c > 5.8% (p < .05, RR=5.4, CI: .1.29- 22.6) and history of HTN or elevated BP (p =.054, RR = 4.33, CI: .97- 19.3) were independently significant factors. Patients with HbA1c > 5.8% or elevated BP or history of HTN at start of R-CHOP turned out to be risk factors for GDM.