Remission of type 2 diabetes after gastrectomy for gastric cancer: diabetes prediction score
- Authors
- Kwon, Yeongkeun; Kwon, Jin-Won; Ha, Jane; Kim, Dohyang; Cho, Jaehyeong; Jeon, Soo Min; Park, Shin-Hoo; Hwang, Jinseub; Kim, Nam Hoon; Park, Sungsoo
- Issue Date
- Jan-2022
- Publisher
- Springer Verlag
- Keywords
- Gastrectomy; Gastric cancer; Type 2 diabetes; Prediction
- Citation
- Gastric Cancer, v.25, no.1, pp 265 - 274
- Pages
- 10
- Indexed
- SCIE
SCOPUS
- Journal Title
- Gastric Cancer
- Volume
- 25
- Number
- 1
- Start Page
- 265
- End Page
- 274
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/53915
- DOI
- 10.1007/s10120-021-01216-2
- ISSN
- 1436-3291
1436-3305
- Abstract
- Background
Although type 2 diabetes (T2D) remission after gastric cancer surgery has been reported, little is known about the predictors of postoperative T2D remission.
Methods
This study used data from a nationwide cohort provided by the National Health Insurance Service in Korea. We developed a diabetes prediction (DP) score, which predicted postoperative T2D remissions using a logistic regression model based on preoperative variables. We applied machine-learning algorithms [random forest, XGboost, and least absolute shrinkage and selection operator (LASSO) regression] and compared their predictive performances with those of the DP score.
Results
The DP score comprised five parameters: baseline body mass index (< 25 or ≥ 25 kg/m2), surgical procedures (subtotal or total gastrectomy), age (< 65 or ≥ 65 years), fasting plasma glucose levels (≤ 130 or > 130 mg/dL), and antidiabetic medications (combination therapy including sulfonylureas, combination therapy not including sulfonylureas, single sulfonylurea, or single non-sulfonylurea]). The DP score showed a clinically useful predictive performance for T2D remission at 3 years after surgery [training cohort: area under the receiver operating characteristics (AUROC) 0.73, 95% confidence interval (CI), 0.71–0.75; validation cohort: AUROC 0.72, 95% CI 0.69–0.75], which was comparable to that of the machine-learning models (random forest: AUROC 0.71, 95% CI 0.68–0.74; XGboost: AUROC 0.70, 95% CI 0.67–0.73; LASSO regression: AUROC 0.75, 95% CI 0.73–0.78 in the validation cohort). It also predicted the T2D remission at 6 and 9 years after surgery.
Conclusions
The DP score is a useful scoring system for predicting T2D remission after gastric cancer surgery.
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- Appears in
Collections - 2. Clinical Science > Department of Endocrinology and Metabolism > 1. Journal Articles
- 2. Clinical Science > Department of Foregut Surgery > 1. Journal Articles
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