Skip to main content
Log in

Prognostic Significance of Hyperglycemia in Patients with Brain Tumors: a Meta-Analysis

  • Published:
Molecular Neurobiology Aims and scope Submit manuscript


Hyperglycemia has been associated with poor outcomes of patients with various diseases. There were several studies published to assess the association between hyperglycemia and prognosis of patients with brain tumors, but no consistent conclusion was available. We therefore performed a meta-analysis of available studies to evaluate the prognostic role of hyperglycemia in brain tumors. Several common databases were searched for eligible studies on the association between hyperglycemia and survival of patients with brain tumors. Two investigators used a set of predefined inclusion criteria to assess eligible studies independently. The pooled hazard ratios (HRs) with 95 % confidence intervals (95 % CIs) were used to assess the prognostic role of hyperglycemia. Finally, seven studies with a total of 2168 patients with brain tumors were included into the meta-analysis. Meta-analysis of total seven studies showed that hyperglycemia was significantly associated with shorter overall survival of brain tumors (HR = 2.04, 95 % CI 1.51–2.76, P < 0.001). Meta-analysis of studies focusing on hyperglycemia showed that hyperglycemia was still significantly associated with shorter overall survival of brain tumors (HR = 1.82, 95 % CI 1.29–2.59, P = 0.001). Meta-analysis of three studies on diabetes showed that diabetes was significantly associated with shorter overall survival of brain tumors (HR = 2.09, 95 % CI 1.22–3.57, P = 0.007). Meta-regression analysis showed that there was no obvious difference in the roles of between hyperglycemia caused by glucocorticoids and hyperglycemia from diabetes (P = 0.25). Thus, hyperglycemia has an obvious prognostic significance in patients with brain tumors, and hyperglycemia is significantly associated with shorter overall survival of brain tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others


  1. de Robles P, Fiest KM, Frolkis AD, Pringsheim T, Atta C, St Germaine-Smith C, Day L, Lam D, Jette N (2014) The worldwide incidence and prevalence of primary brain tumors: a systematic review and meta-analysis. Neuro Oncol

  2. Li J, Sulman E, Aldape K (2012) Molecular biology of brain tumors. Handb Clin Neurol 10423–34

  3. Schiff D, Lee EQ, Nayak L, Norden AD, Reardon DA, Wen PY (2014) Medical management of brain tumors and the sequelae of treatment. Neuro Oncol

  4. Hummel R, Maurer J, Haier J (2011) MicroRNAs in brain tumors : a new diagnostic and therapeutic perspective? Mol Neurobiol 44(3):223–234

    Article  CAS  PubMed  Google Scholar 

  5. Chen LY, Liu LB, Li XX, Yu Q, Yu B, Hong Y, Zheng J, Xue YX, Liu YH (2014) Prognostic Significance of Osteopontin and Carbonic Anhydrase 9 in Human Brain Tumors: A Meta-Analysis. Mol Neurobiol

  6. Klingelhofer L, Mucha D, Geiger K, Koch R, von Kummer R (2014) Prognostic Value of Conventional Magnetic Resonance Imaging for Adult Patients with Brain Tumors. Clin Neuroradiol

  7. Badrick E, Renehan AG (2014) Diabetes and cancer: 5 years into the recent controversy. Eur J Cancer 50(12):2119–2125

    Article  PubMed  Google Scholar 

  8. Krone CA, Ely JT (2005) Controlling hyperglycemia as an adjunct to cancer therapy. Integr Cancer Ther 4(1):25–31

    Article  PubMed  Google Scholar 

  9. Pernicova I, Korbonits M (2014) Metformin–mode of action and clinical implications for diabetes and cancer. Nat Rev Endocrinol 10(3):143–156

    Article  CAS  PubMed  Google Scholar 

  10. Ryu TY, Park J, Scherer PE (2014) Hyperglycemia as a risk factor for cancer progression. Diabetes Metab J 38(5):330–336

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bebawy JF (2012) Perioperative steroids for peritumoral intracranial edema: a review of mechanisms, efficacy, and side effects. J Neurosurg Anesthesiol 24(3):173–177

    Article  PubMed  Google Scholar 

  12. Ciriaco M, Ventrice P, Russo G, Scicchitano M, Mazzitello G, Scicchitano F, Russo E (2013) Corticosteroid-related central nervous system side effects. J Pharmacol Pharmacotherapy 4(Suppl 1):S94–S98

    Google Scholar 

  13. Donihi AC, Raval D, Saul M, Korytkowski MT, DeVita MA (2006) Prevalence and predictors of corticosteroid-related hyperglycemia in hospitalized patients. Endocr Pract 12(4):358–362

    Article  PubMed  Google Scholar 

  14. McGirt MJ, Chaichana KL, Gathinji M, Attenello F, Than K, Ruiz AJ, Olivi A, Quinones-Hinojosa A (2008) Persistent outpatient hyperglycemia is independently associated with decreased survival after primary resection of malignant brain astrocytomas. Neurosurgery 63(2):286–291, discussion 291

    Article  PubMed  Google Scholar 

  15. Derr RL, Ye X, Islas MU, Desideri S, Saudek CD, Grossman SA (2009) Association between hyperglycemia and survival in patients with newly diagnosed glioblastoma. J Clin Oncol 27(7):1082–1086

    Article  PubMed  PubMed Central  Google Scholar 

  16. Chaichana KL, McGirt MJ, Woodworth GF, Datoo G, Tamargo RJ, Weingart J, Olivi A, Brem H, Quinones-Hinojosa A (2010) Persistent outpatient hyperglycemia is independently associated with survival, recurrence and malignant degeneration following surgery for hemispheric low grade gliomas. Neurol Res 32(4):442–448

    Article  PubMed  Google Scholar 

  17. Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC (2012) Type 2 diabetes mellitus and obesity are independent risk factors for poor outcome in patients with high-grade glioma. J Neurooncol 106(2):383–389

    Article  PubMed  Google Scholar 

  18. Welch MR, Grommes C (2013) Retrospective analysis of the effects of steroid therapy and antidiabetic medication on survival in diabetic glioblastoma patients. CNS Oncol 2(3):237–246

    Article  CAS  PubMed  Google Scholar 

  19. Chambless LB, Kistka HM, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC (2014) The relative value of postoperative versus preoperative Karnofsky Performance Scale scores as a predictor of survival after surgical resection of glioblastoma multiforme. J Neurooncol

  20. Wells G, Shea B, O’connell D, Peterson J, Welch V, Losos M, Tugwell P (2014) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Health Research Institute Web site

  21. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560

    Article  PubMed  PubMed Central  Google Scholar 

  22. Cochran WG (1954) The combination of estimates from different experiments. Biometrics 10(1):101–129

    Article  Google Scholar 

  23. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188

    Article  CAS  PubMed  Google Scholar 

  24. Mantel N, Haenszel W (1959) Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 22(4):719–748

    CAS  PubMed  Google Scholar 

  25. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Link TW, Woodworth GF, Chaichana KL, Grossman SA, Mayer RS, Brem H, Weingart JD, Quinones-Hinojosa A (2012) Hyperglycemia is independently associated with post-operative function loss in patients with primary eloquent glioblastoma. J Clin Neurosci 19(7):996–1000

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Wu HJ, Che YJ, Ju DH, Liang P, Liu EZ (2011) Related factors of early post-operative prognosis of meningiomas: an analysis of 953 surgical cases. Zhonghua Yi Xue Za Zhi 91(15):1051–1054

    PubMed  Google Scholar 

  28. Cohen-Inbar O, Soustiel JF, Zaaroor M (2010) Meningiomas in the elderly, the surgical benefit and a new scoring system. Acta Neurochir (Wien) 152(1):87–97, discussion 97

    Article  Google Scholar 

  29. Mayer A, Vaupel P, Struss HG, Giese A, Stockinger M, Schmidberger H (2014) Strong adverse prognostic impact of hyperglycemic episodes during adjuvant chemoradiotherapy of glioblastoma multiforme. Strahlenther Onkol 190(10):933–938

    Article  PubMed  Google Scholar 

  30. Mergenthaler P, Lindauer U, Dienel GA, Meisel A (2013) Sugar for the brain: the role of glucose in physiological and pathological brain function. Trends Neurosci 36(10):587–597

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Oudard S, Arvelo F, Miccoli L, Apiou F, Dutrillaux AM, Poisson M, Dutrillaux B, Poupon MF (1996) High glycolysis in gliomas despite low hexokinase transcription and activity correlated to chromosome 10 loss. Br J Cancer 74(6):839–845

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Giovannucci E, Harlan DM, Archer MC, Bergenstal RM, Gapstur SM, Habel LA, Pollak M, Regensteiner JG, Yee D (2010) Diabetes and cancer: a consensus report. CA Cancer J Clin 60(4):207–221

    Article  PubMed  Google Scholar 

  33. Onitilo AA, Engel JM, Glurich I, Stankowski RV, Williams GM, Doi SA (2012) Diabetes and cancer I: risk, survival, and implications for screening. Cancer Causes Control 23(6):967–981

    Article  PubMed  PubMed Central  Google Scholar 

  34. Gallagher EJ, LeRoith D (2011) Diabetes, cancer, and metformin: connections of metabolism and cell proliferation. Ann N Y Acad Sci 1243:54–68

    Article  CAS  PubMed  Google Scholar 

  35. Richardson LC, Pollack LA (2005) Therapy insight: Influence of type 2 diabetes on the development, treatment and outcomes of cancer. Nat Clin Pract Oncol 2(1):48–53

    Article  PubMed  Google Scholar 

Download references

Conflict of Interests

We declare that we have no conflicts of interest.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Jinfang Liu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, H., Liu, Z., Jiang, B. et al. Prognostic Significance of Hyperglycemia in Patients with Brain Tumors: a Meta-Analysis. Mol Neurobiol 53, 1654–1660 (2016).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: