Immune checkpoint inhibitor-induced diabetes mellitus: clinical characteristics and risk factors.

IF 5.9 2区 医学 Q1 IMMUNOLOGY Frontiers in Immunology Pub Date : 2025-01-24 eCollection Date: 2025-01-01 DOI:10.3389/fimmu.2025.1499074
Mei Zhan, Qinran Long, Jinhan He, Litao Huang, Bin Wu, Haixia Xu, Li Mo, Ting Xu
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Abstract

Background: Emerging evidence indicates that immune checkpoint inhibitor-induced diabetes mellitus (ICI-DM) might be more common than initially reported, and more different clinical pictures associated with ICI-DM were described.

Objective: The aim of our study was to identify the clinical characteristics and possible predictive factors of ICI-DM.

Methods: We conducted a retrospective review of patients who received immune checkpoint inhibitors (ICI) at West China Hospital, Sichuan University until June 2023. Patients were reviewed at death or on 7 May 2024. We applied logistic regression to study the associations between clinical characteristics and ICI-DM.

Results: Our study included 8,199 participants who received ICI between October 2014 and June 2023. Among them, 1,077 patients (13.14%) developed ICI-DM according to diagnostic criteria based on guidelines. By excluding patients influenced by glucocorticoids or immunosuppressants, ICI-DM was observed in 713 of 8,199 (8.70%) patients. In all patients, hypertension, hyperlipidemia, using glucocorticoids or immunosuppressants, lung cancer, and using more than one pathway of ICI were associated with a higher risk of ICI-DM. However, the risk factors for ICI-DM in patients without the influence of glucocorticoids or immunosuppressants were only hypertension, hyperlipidemia, and pancreatic lesions. In all patients and those patients without the influence of glucocorticoids and immunosuppressants, hypertension and hyperlipidemia may increase the risk for ICI-DM.

Conclusions: This large, real-world cohort demonstrates that the incidence of ICI-DM may be underestimated in previous literature. Blood glucose monitoring is needed in patients receiving ICI therapy.

Clinical trial registration: https://www.chictr.org.cn, identifier ChiCTR2300075974.

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免疫检查点抑制剂诱导的糖尿病:临床特点及危险因素。
背景:新出现的证据表明,免疫检查点抑制剂诱导的糖尿病(ICI-DM)可能比最初报道的更常见,并且描述了更多与ICI-DM相关的不同临床症状。目的:探讨ICI-DM的临床特点及可能的预测因素。方法:我们对截至2023年6月在四川大学华西医院接受免疫检查点抑制剂(ICI)治疗的患者进行回顾性分析。患者在死亡时或2024年5月7日接受复查。我们应用逻辑回归研究临床特征与ICI-DM之间的关系。结果:我们的研究纳入了2014年10月至2023年6月期间接受ICI的8,199名参与者。其中1077例(13.14%)患者按照指南诊断标准发展为ICI-DM。通过排除受糖皮质激素或免疫抑制剂影响的患者,8199例患者中有713例(8.70%)出现ICI-DM。在所有患者中,高血压、高脂血症、使用糖皮质激素或免疫抑制剂、肺癌以及使用多种ICI途径与ICI- dm的高风险相关。然而,在没有糖皮质激素或免疫抑制剂影响的患者中,ICI-DM的危险因素仅为高血压、高脂血症和胰腺病变。在所有患者和那些没有糖皮质激素和免疫抑制剂影响的患者中,高血压和高脂血症可能增加ICI-DM的风险。结论:这个庞大的现实世界队列表明,在以前的文献中,ICI-DM的发病率可能被低估了。接受ICI治疗的患者需要进行血糖监测。临床试验注册:https://www.chictr.org.cn,标识符ChiCTR2300075974。
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来源期刊
CiteScore
9.80
自引率
11.00%
发文量
7153
审稿时长
14 weeks
期刊介绍: Frontiers in Immunology is a leading journal in its field, publishing rigorously peer-reviewed research across basic, translational and clinical immunology. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Immunology is the official Journal of the International Union of Immunological Societies (IUIS). Encompassing the entire field of Immunology, this journal welcomes papers that investigate basic mechanisms of immune system development and function, with a particular emphasis given to the description of the clinical and immunological phenotype of human immune disorders, and on the definition of their molecular basis.
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