Cardiovascular Prevention and Pharmacotherapy

Volume 5(3); July 2023

Review Article

Diabetes mellitus and cancer: Jae Won Hong; Cardiovasc Prev Pharmacother. 2023;5(3):69-73. Published online July 27, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e9

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Abstract PDF: Diabetes mellitus and cancer are the most common life-threatening illnesses worldwide. Previous epidemiological studies have suggested a strong association between diabetes mellitus and an increased risk of cancer. Potential biological mechanisms underlying this relationship include obesity, hyperglycemia, hyperinsulinemia, chronic inflammation, and oxidative stress. The most common diabetes-related cancers are pancreatic, hepatocellular, breast, endometrial, and colorectal cancer. Special attention should be paid to patients with diabetes through careful cancer screening and preventive anticancer strategies.

Original Articles

Obesity and 30-day case fatality after hyperglycemic crisis hospitalizations in Korea: a national cohort study: Hojun Yoon, Hyun Ho Choi, Giwoong Choi, Sun Ok Song, Kyoung Hwa Ha, Dae Jung Kim; Cardiovasc Prev Pharmacother. 2023;5(3):74-80. Published online July 27, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e10

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Abstract PDF Supplementary Material: Background
We determined the case fatality rate associated with hospitalization due to hyperglycemic crises and investigated the relationship between obesity status and case fatality for hyperglycemic crises.
Methods
From the Korean National Health Insurance Service-National Sample Cohort, 729 adults who visited the emergency room or were hospitalized due to hyperglycemic crises between January 1, 2010, and December 31, 2019, were included. Preobesity or obesity was defined as a body mass index ≥23.0 kg/m2. Case fatality rates are presented as the proportion of adults who died within 30 days of hospitalization. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for 30-day fatalities according to preobesity or obesity status.
Results
The 30-day case fatality rate for hyperglycemic crises was 11.2%. In those aged ≥65 years, the fatality rate was twice as high as that in those aged 20 to 64 years (13.8% vs. 6.8%). Adults with preobesity or obesity had a lower fatality rate than those with normal weight (9.5% vs. 14.0%). After adjustment for confounding variables, preobesity or obesity was found to be significantly associated with a decreased risk for 30-day case fatality compared to normal weight (HR, 0.63; 95% CI, 0.40–0.98).
Conclusions
In Korea, hyperglycemic crises had a high fatality rate. Management needs to be improved to prevent hyperglycemic crises and reduce mortality.

Relationship between serum ferritin levels during iron chelating therapy and diastolic left ventricular function in transfusion-induced iron overload: a 2-year follow-up study in patients with aplastic anemia: Woo-Baek Chung; Cardiovasc Prev Pharmacother. 2023;5(3):81-90. Published online July 26, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e11

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Abstract PDF: Background
The goal of the study was to investigate changes in cardiac function during iron chelating therapy (ICT) in patients with transfusion-induced iron overload.
Methods
We prospectively examined cardiac function in 21 aplastic anemia patients for 2 years by using transthoracic echocardiography before and during ICT.
Results
The serum ferritin level decreased from 4,961.5±2,917.9 µg/L to 2,466.9±2,533.1 µg/L after 2 years (P<0.001). The left ventricular ejection fraction decreased to under the normal limit (55%) in five patients. The serum ferritin level was positively correlated with the E/E’ ratio (r=0.595, P=0.004) and the left atrial (LA) volume (r=0.685, P=0.001) and negatively correlated with the deceleration time (r=–0.586, P=0.005) after 2 years of ICT. The seven responders (serum ferritin level <1,000 µg/L after 2 years of ICT) demonstrated a significantly higher ejection fraction, smaller LA volume and left ventricular end-systolic dimension, and a slower deceleration time than the 14 nonresponders (≥1,000 µg/L).
Conclusions
These results suggest that the response to ICT, which was estimated by the serum ferritin level, can reflect cardiac function during ICT. In nonresponders, cardiac function monitoring during ICT may be helpful for the early detection of cardiac dysfunction.

Correlation between metformin intake and prostate cancer: Raeun Kim, Minsun Song, Jiwon Shinn, Hun-Sung Kim; Cardiovasc Prev Pharmacother. 2023;5(3):91-97. Published online July 31, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e12

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Abstract PDF: Background
The relationship between metformin intake and prostate cancer incidence remains unclear. Therefore, we examined the correlation between prostate cancer and metformin use.
Methods
The subjects were diabetes patients aged ≥50 years who had been diagnosed with prostate cancer and had undergone surgery at Seoul St. Mary's Hospital. Groups taking metformin (MET(+) group) and not taking metformin (MET(–) group) were divided and compared.
Results
The mean preoperative prostate-specific antigen (PSA) levels in the MET(–) and MET(+) groups were 10.7±11.9 and 8.0±5.6 ng/mL, respectively, with no statistically significant difference between the two groups (P=0.387). The average prostate volume of the MET(–) group was 82.4±98.0 mL, and the average prostate volume of the MET(+) group was 55.4±20.1 mL, but there was no statistically significant difference between the two groups (P=0.226). The mean PSA velocity also did not show a significant difference between the two groups (0.025±0.102 ng/mL vs. 0.005±0.012 ng/mL, P=0.221).
Conclusions
We did not identify a significant positive correlation between metformin and prostate cancer. However, preoperational PSA and PSA velocity tended to be lower in the MET(+) group. A sophisticated prospective study with a large sample size should be planned.

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