Longitudinal study of central obesity and glucose-lipid metabolism in predicting tumor remission among fertility-sparing endometrial cancer patients

纵向研究中心性肥胖和葡萄糖-脂质代谢在预测保留生育功能的子宫内膜癌患者肿瘤缓解中的作用

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Abstract

OBJECTIVE: This study aimed to predict tumor remission by monitoring obesity-parameter changes during weight loss in EC patients and to identify the most reliable indicators for forecasting tumor complete remission (CR). METHODS: A prospective longitudinal study was conducted to track changes in obesity parameters during a 6-month weight-loss period and to predict 9-month CR. Body morphology indicators, including weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), lipid accumulation product (LAP), and body roundness index (BRI), and metabolic measures such as triglycerides (TG), hemoglobin A1c (HbA1c), fasting insulin (FINS), and insulin resistance (IR) were assessed. Multivariable logistic regression was used to evaluate associations between these parameters and CR, and receiver operating characteristic (ROC) analyses were performed to determine optimal cut-off values for predicting remission. RESULTS: A total of 84 patients were included. Multivariable logistic regression identified WHR as a significant independent predictor for CR (P = 0.015, OR=1.111 95% CI: 1.021-1.209). ROC analysis revealed optimal cut-off values for WHR (0.90), TG (1.38), and FINS (18.93). The AUC values were 0.71, 0.63, and 0.67 respectively, indicating moderate predictive value. Calibration and decision curve analyses confirmed the models' stability and clinical benefit. CONCLUSIONS: WHR may serve as an additional predictor of obesity in CR. of obesity for CR. It is a convenient and quick method for monitoring and developing individualized treatments for fertility preservation and weight reduction strategies.

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