Metabolic disorders in patients with common cancers

Metabolic reprogramming is a prominent feature of cancer cells, and metabolic disorders seriously impair the prognosis of patients with cancer. This study investigated the metabolic disorders and metabolic load in patients with common cancers. A total of 15762 INSCOC patients were included in the study, and 21 blood indexes were used to quantitatively evaluate the metabolic disorders and metabolic load of patients. It was defined as a metabolic disorder if outside the normal range, and was counted as 1 point. Then the metabolic disorder load of the patient was calculated. One-way analysis of variance was used to compare the metabolic load of patients with common cancers. The rate of metabolic disorders was 96.0%, and only 4% (640 cases) of the patients were within the normal range. The top three indexes with the highest metabolic disorder rate were low-density lipoprotein cholesterol (45.7%), total cholesterol (34.2%) and prealbumin (30.0%). The top three indicators with the lowest metabolic disorders were high-density lipoprotein cholesterol (0.5%), albumin (4.0%), and total protein (5.1%). The incidence of metabolic disorders was different among cancer types, gender, age, TNM stage and treatment mode (P​≥70 years old), among which the metabolic disorder load of prostate cancer patients in the ≥70 years old (7.00±4.25). The metabolic disorder load of women was higher than that of men (4.26±2.51 vs. 4.09±2.58, P=0.050). The metabolic disorder load of patients with different TNM stages was stage I: 3.39±2.17, stage II: 3.72±2.23, stage III: 3.84±2.33, and stage IV: 4.57±2.71, respectively. In patients with cervical and pancreatic cancer, immunotherapy increases the metabolic burden. Among the malignant tumors with diabetes mellitus and hypertension, the metabolic disorder load was the highest in patients with biliary malignancy (6.95±2.94, 6.22±3.30). Among smoking and drinking patients, liver cancer patients had the highest metabolic disorder load (5.66±3.04, 5.80±3.17). This study shows that the incidence of metabolic disorders is high and the burden of metabolic disorders is heavy in patients with cancer. This study emphasizes the importance and necessity of maintaining the stability of the internal environment of patients with cancer and implementing metabolic regulation therapy. Moreover, for the first time in a large sample study, it was unexpectedly found that the metabolic disorder rate of albumin and total protein in patients with cancer was significantly lower than that reported in the traditional literature, suggesting that the diagnosis of malnutrition in patients with cancer should not rely on albumin or total protein, and malnutrition and hypoproteinemia should be distinguished.