مجله دانشکده پزشکی اصفهان

مجله دانشکده پزشکی اصفهان

مقایسه‌ی الگوی شیوع فشار خون بالا و دیابت نوع 2 در بیماران مبتلا به سرطان کولورکتال

نوع مقاله : مقاله های پژوهشی

نویسندگان
علی احمدی 1
سید سعید هاشمی نظری 2
زهرا مولوی چوبینی 3
حمید نصری 4
1 استادیار، گروه اپیدمیولوژی و آمارزیستی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران
2 استادیار، گروه اپیدمیولوژی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران
3 معاونت تحقیقات و فناوری، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران
4 استاد، گروه نفرولوژی، دانشکده‌‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
چکیده
مقدمه: سرطان کولورکتال شایع‌ترین سرطان دستگاه گوارش می‌باشد و 10 درصد مرگ و میر ناشی از سرطان را شامل می‌شود. در ایران، میزان فراوانی سرطان کولورکتال در دهه‌های اخیر افزایش چشمگیری داشته است. تا کنون مطالعه‌ای در ایران به بررسی شیوع فشار خون بالا و دیابت نوع دو و اثر آن‌ها بر بقای بیماران مبتلا به سرطان کولورکتال نپرداخته است. این مطالعه به این منظور انجام گردید.روش‌ها: این مطالعه یک بررسی هم‌گروهی بود که در آن، 1127 بیمار مبتلا به سرطان کولورکتال در مرکز ثبت سرطان وابسته به مرکز تحقیقات گوارش و کبد دانشگاه علوم پزشکی شهید بهشتی در 2570 نفر- سال پیگیری شدند. برای تشخیص دیابت نوع دو، از آزمایش قند خون ناشتا و هموگلوبین گلیکوزیله استفاده گردید. برای تشخیص فشار خون بالا از اندازه‌گیری فشار خون افراد در دو نوبت استفاده گردید. شاخص‌های توصیفی محاسبه و با استفاده از آنالیز بقا، میانه‌ی زمان بقای بیماران از تشخیص بیماری محاسبه و با آزمون Log-rank زمان بقای آن‌ها مقایسه‌ گردید. از نرم‌‌افزار Stata نسخه‌ی 12 برای تجزیه و تحلیل داده‌ها استفاده شد.یافته‌ها: شیوع فشار خون بالا و دیابت نوع دو در بیماران مبتلا به سرطان کولورکتال به ترتیب 38/13 درصد (با فاصله اطمینان 95 درصد: 8/15-1/11) و 69/8 درصد (با فاصله اطمینان 95 درصد: 7/10-0/7) بود. میانه‌ی زمان بقا در این بیماران به ترتیب 52/8 و 9/4 سال بود. بر اساس آزمون Log-rank تفاوت معنی‌داری بین بقای بیماران مبتلا به سرطان کولورکتال که به فشار خون بالا و دیابت نوع دو نیز مبتلا بودند، مشاهده نگردید (818/0 = P).نتیجه‌گیری: شیوع فشار خون بالا، بیشتر از دیابت است و با وجود کاهش بقای بیماران مبتلا به دیابت نوع دو در مقایسه با پرفشاری خون، دو بیماری متابولیک بر میزان بقای بیماران مبتلا به سرطان کولورکتال اثر یکسانی دارند. 
کلیدواژه‌ها
سرطان کولورکتال
میانه‌ی زمان بقا
پرفشاری خون
دیابت نوع دو

عنوان مقاله English

Comparing the Patterns of Hypertension and Type 2 Diabetes Mellitus in Patients with Colorectal Cancer

نویسندگان English

Hamid Nasri 4
Seyyed-Saeed Hashemi-Nazari 2
Zahra Molavi-Choobini 3
1 Assistant Professor, Department of Epidemiology and Biostatistics, School of Public Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Assistant Professor, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Research and Technology Deputy, Shahrekord University of Medical Sciences, Shahrekord, Iran
4 Professor, Department of Nephrology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده English

Background: Type 2 diabetes mellitus (DM) and hypertension are worldwide epidemic. Colorectal cancer (CRC) is the most prevalent gastrointestinal cancer in Iran. Prevalence of type 2 diabetes mellitus and hypertension in the patients with colorectal cancer had not reported in Iran, before this study.Methods: Overall, 2570 individual-year follow-ups were conducted for 1127 patients with colorectal cancer. For diagnosis of type 2 diabetes mellitus, fasting blood sugar and glycosylated hemoglobin tests were used and for that of hypertension, blood pressure was measured in two turns. The descriptive indices were calculated and the mean and median survivals, from colorectal cancer diagnosis time, were calculated using survival analysis and the comparison among survival times was done through log-rank test. Stata12 software  was used for data analysis.Findings: The prevalences of hypertension and type 2 diabetes mellitus in the patients with colorectal cancer were 13.38% (95% CI: 11.1-15.8) and 8.69% (95% CI: 7.0-10.7), respectively. Median survival time in patients with hypertension and diabetes mellitus were 8.52 and 4.90 years, respectively. According to log-rank test, no significant difference was observed between the survival time of patients with colorectal cancer suffering from hypertension and type 2 diabetes mellitus.Conclusion: The obtained findings in this study indicate that survival time in patients with type 2 diabetes mellitus is less than those with hypertension; but two metabolic diseases have same effect on survival rate of the patients with colorectal cancer.

کلیدواژه‌ها English

Colorectal Cancer
Median survival time
Hypertension
Type 2 Diabetes Mellitus
  1. Hosseinzadeh A, Daraei A. Environmental factors associated with sporadic colorectal cancer. J Health Syst Res 2012; 8(2): 229-36. [In Persian].
  2. Mohammdzadeh M, Maghbouli L, Ahmadi Dashatan R. Prevalence of risk factors of rectal cancer among 100 patients referred to radiotherapy department of Emam Reza University Hospital at Tabriz University of Medical Sciences-Tabriz. Iran. Med J Tabriz Univ Med Sci 2013; 35(2): 84-9. [In Persian].
  3. Akhoond MR, Kazemnejad A, Hajizadeh E, Ganbary Motlagh A, Zali MR. Comparison of influential factors affecting survival of patients with colon and rectum cancer using competing risks model. Koomesh 2010; 12(2): 119-28. [In Persian].
  4. Ahmadi A, Hashemi Nazari SS, Mobasheri M. Does ethnicity affect survival following colorectal cancer? A prospective, cohort study using Iranian cancer registry. Med J I R Iran 2014; 28(1): 83-9.
  5. Asghari-Jafarabadi M, Hajizadeh E, Kazemnejad A, Fatemi SR. Recognition of the factors affecting survival in colon and rectal cancer patients referred to RCGLD center of Shahid Beheshti University of Medical Sciences: accelerated failure time parametric survival analysis with frailty. J Shahrekord Univ Med Sci 2010; 12(2): 51-64. [In Persian].
  6. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61(2): 69-90.
  7. Ahmadi A, Mobasheri M, Hashemi Nazari SS. Survival time and relative risk of death in patients with colorectal cancer in an Iranian population: a cohort study. J Mazandaran Univ Med Sci 2014; 24(111): 2-8. [In Persian].
  8. Ansari R, Mahdavinia M, Sadjadi A, Nouraie M, Kamangar F, Bishehsari F, et al. Incidence and age distribution of colorectal cancer in Iran: results of a population-based cancer registry. Cancer Lett 2006; 240(1): 143-7.
  9. Fateh Sh, Mahmoud A. An epidemiologic study of colorectal cancer in Arak during 1994-2004. Iran J Surg 2008; 16(2): 11-7. [In Persian].
  10. Mehrabani D, Almasi-Hashiani A. Evaluation of the 5-year survival rate and demographic factors in colorectal cancer patients. J Zanjan Univ Med Sci 2012; 20(82): 12-9.[In Persian].
  11. Ahmadi A, Hasanzadeh A, Rajaeifard A. Metabolic control and care assessment in patients with type 2 diabetes In Chaharmahal and Bakhtiyari province 2008. Iran J Endocrinol Metab 2009; 11(1): 33-9. [In Persian].
  12. Ahmadi A, Hasanzadeh J, Rajaefard A. To determine the relative factors on hypertension in Kohrang, Chaharmahal and Bakhtiari Province, 2007. Iran J Epidemiol 2008; 4(2): 19-25. [In Persian].
  13. Ahmadi A, Soori H, Mehrabi Y, Etemad K, Samavat T, Khaledifar A. Incidence of acute myocardial infarction in Islamic Republic of Iran: a study using national registry data in2012. East Mediterr Health J 2014. [In Press].
  14. Ragozzino M, Melton III LJ, Chu CP, Palumbo PJ. Subsequent cancer risk in the incidence cohort of Rochester, Minnesota, residents with diabetes mellitus. Journal of Chronic Diseases 1982; 35(1): 13-9.
  15. Adami HO, McLaughlin J, Ekbom A, Berne C, Silverman D, Hacker D, et al. Cancer risk in patients with diabetes mellitus. Cancer Causes Control 1991; 2(5): 307-14.
  16. O'Mara BA, Byers T, Schoenfeld E. Diabetes mellitus and cancer risk: a multisite case-control study. J Chronic Dis 1985; 38(5): 435-41.
  17. Kune GA, Kune S, Watson LF. Colorectal cancer risk, chronic illnesses, operations, and medications: case control results from the Melbourne Colorectal Cancer Study. Cancer Res 1988; 48(15): 4399-404.
  18. La VC, D'Avanzo B, Negri E, Franceschi S. History of selected diseases and the risk of colorectal cancer. Eur J Cancer 1991; 27(5): 582-6.
  19. Hardell L, Fredrikson M, Axelson O. Case-control study on colon cancer regarding previous diseases and drug intake. Int J Oncol 1996; 8(3): 439-44.
  20. Potter JD. Reconciling the epidemiology, physiology, and molecular biology of colon cancer. JAMA 1992; 268(12): 1573-7.
  21. Iber FL, Parveen S, Vandrunen M, Sood KB, Reza F, Serlovsky R, et al. Relation of symptoms to impaired stomach, small bowel, and colon motility in long-standing diabetes. Dig Dis Sci 1993; 38(1): 45-50.
  22. Baradaran A, Nasri H, Rafieian-Kopaei M. Oxidative stress and hypertension: Possibility of hypertension therapy with antioxidants. J Res Med Sci 2014; 19(4): 358-67.
  23. Janatuinen E, Pikkarainen P, Laakso M, Pyorala K. Gastrointestinal symptoms in middle-aged diabetic patients. Scand J Gastroenterol 1993; 28(5): 427-32.
  24. Will JC, Galuska DA, Vinicor F, Calle EE. Colorectal cancer: another complication of diabetes mellitus? Am J Epidemiol 1998; 147(9): 816-25.
  25. Fung TT, Hu FB, Wu K, Chiuve SE, Fuchs CS, Giovannucci E. The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets and colorectal cancer. Am J Clin Nutr 2010; 92(6): 1429-35.
  26. Tahover E, Uziely B, Salah A, Temper M, Peretz T, Hubert A. Hypertension as a predictive biomarker in bevacizumab treatment for colorectal cancer patients. Med Oncol 2013; 30(1): 327.
  27. Osterlund P, Soveri LM, Isoniemi H, Poussa T, Alanko T, Bono P. Hypertension and overall survival in metastatic colorectal cancer patients treated with bevacizumab-containing chemotherapy. Br J Cancer 2011; 104(4): 599-604.
  28. Horinouchi Y, Sakurada T, Nakamura T, Tajima S, Nishisako H, Abe S, et al. Hypertension as a predictive factor of effect of bevacizumab in treatment of colorectal cancer. Yakugaku Zasshi 2011; 131(8): 1251-7.
  29. De SA, Carlomagno C, Pepe S, Bianco R, De PS. Bevacizumab-related arterial hypertension as a predictive marker in metastatic colorectal cancer patients. Cancer Chemother Pharmacol 2011; 68(5): 1207-13.
  30. Rahimi Z, Mansouri ZO, Rahimi Z, Abbasi A. AT2R -1332 G:A polymorphism and diabetic nephropathy in type 2 diabetes mellitus patients. J Renal Inj Prev 2013; 2(3): 97-101.
  31. Nasri H. Comment on: A model for prediction of cisplatin induced nephrotoxicity by kidney weight in experimental rats. J Res Med Sci 2013; 18(12): 1119-20.
  32. Scartozzi M, Galizia E, Chiorrini S, Giampieri R, Berardi R, Pierantoni C, et al. Arterial hypertension correlates with clinical outcome in colorectal cancer patients treated with first-line bevacizumab. Ann Oncol 2009; 20(2): 227-30.
  33. Ryanne WR, Lindenberg PA, Slack R, Noone AM, Marshall JL, He AR. Evaluation of hypertension as a marker of bevacizumab efficacy. J Gastrointest Cancer 2009; 40(3-4): 101-8.
  34. Nasri H, Rafieian-Kopaei M. Protective effects of herbal antioxidants on diabetic kidney disease. J Res Med Sci 2014; 19(1): 82-3.
  35. Dewdney A, Cunningham D, Barbachano Y, Chau I. Correlation of bevacizumab-induced hypertension and outcome in the BOXER study, a phase II study of capecitabine, oxaliplatin (CAPOX) plus bevacizumab as peri-operative treatment in 45 patients with poor-risk colorectal liver-only metastases unsuitable for upfront resection. Br J Cancer 2012; 106(11): 1718-21.
  36. Othman NH, Zin AA. Association of colorectal carcinoma with metabolic diseases; experience with 138 cases from Kelantan, Malaysia. Asian Pac J Cancer Prev 2008; 9(4): 747-51.
  37. Mobasheri M, Ahmadi A. Incidence patterns and spatial analysis of the most common cancers in southeastern Iran using Geographic Information System (GIS). Acad J Canc Res 2014; 7(2): 141-5.
  38. Ahmadi A, Hasanzadeh J, Ghaem H, Khosravi S, Reisi R. The survey of family history of diabetes in patients with type 2 diabetes in Chaharmahal va Bakhteyari province, Iran, 2008. J Shahrekord Univ Med Sci 2009; 11(2): 1-7. [In Persian].
  39. Ajabshir S, Asif A, Nayer A. The effects of vitamin D on the renin-angiotensin system. J Nephropathol 2014; 3(2): 41-3.
  40. Ardalan MR, Nasri H. Acute kidney injury; the focus of world kidney day in 2013. J Nephropharmacol 2013; 2(2): 15-6.
  41. Nasri H, Yazdani M. The relationship between serum LDL-cholesterol, HDL-cholesterol and systolic blood pressure in patients with type 2 diabetes. Kardiol Pol 2006; 64(12): 1364-8.
  42. Nasri H. The awareness of chronic kidney disease and aging; the focus of world kidney day in 2014. J Nephropharmacol 2014; 3(1): 1-2.
  43. Baradaran A, Behradmanesh S, Nasri H. Association of body mass index and serum vitamin D level in healthy Iranian adolescents. Endokrynol Pol 2012; 63(1): 29-33.
  44. Ardalan MR, Sanadgol H, Nasri H, Baradaran A, Tamadon MR, Rafieian-Kopaei R. Impact of vitamin D on the immune system in kidney disease. J Parathyr Dis 2013; 1(2): 17-20.
  45. Nasri H. On the occasion of the world diabetes day 2013; diabetes education and prevention; a nephrology point of view. J Renal Inj Prev 2013; 2(2): 31-2.
  46. Ardalan MR, Sanadgol H, Nasri H, Baradaran A, Tamadon MR, Rafieian-Kopaei R. Vitamin D therapy in diabetic kidney disease; current knowledge on a public health problem. J Parathy Dis 2014; 2(1): 15-7.
مجله دانشکده پزشکی اصفهان
دوره 32، شماره 302 - شماره پیاپی 302
مهر و آبان 1393
صفحه 1537-1545

  • تاریخ دریافت 30 خرداد 1393
  • تاریخ پذیرش 17 فروردین 1401