Diabetes associated with pancreatic ductal adenocarcinoma is just diabetes: Results of a prospective observational study in surgical patients

医学 胰腺导管腺癌 观察研究 糖尿病 普通外科 内科学 前瞻性队列研究 肿瘤科 胰腺癌 癌症 内分泌学
作者
Erica Dugnani,Alessandra Gandolfi,Gianpaolo Balzano,Marina Scavini,Valentina Pasquale,Francesca Aleotti,Diego Liberati,Gaetano Di Terlizzi,Giovanna Petrella,Michele Reni,Claudio Doglioni,Emanuele Bosi,Massimo Falconi,Lorenzo Piemonti
出处
期刊:Pancreatology [Elsevier BV]
卷期号:16 (5): 844-852 被引量:14
标识
DOI:10.1016/j.pan.2016.08.005
摘要

Identification of a specific diabetes signature associated to pancreatic ductal carcinoma (PDAC) could be a key to detect asymptomatic, early stage tumors. We aim to characterize the clinical signature and the pathogenetic factors of the different types of diabetes associated with PDAC, based on the time between diabetes and cancer diagnosis. Prospective observational study on 364 PDAC patients admitted to a referral center for pancreatic disease. Hospital and/or outpatient medical records were reviewed. Blood biochemical values including fasting blood glucose, insulin and/or C-peptide, glycosylated hemoglobin and anti-islet antibodies were determined. Diabetes onset was assessed after surgery and during follow-up. The prevalence of diabetes in patients was 67%. Considering 174 patients (47.8%) already having diabetes when diagnosed with PDAC (long duration, short duration, concomitant), the clinical and biochemical profile was similar to that of patients with type 2 diabetes (T2D). Diabetes was associated with known risk factors (i.e., age, sex, family history for diabetes and increased BMI) and both beta-cell dysfunction and insulin resistance were present. Considering 70 patients (19.2%) with onset of diabetes after PDAC diagnosis (early and late onset), the strongest predictor was the loss of beta-cell mass following pancreatectomy in patients with risk factors for T2D. Different types of diabetes according to the time between diabetes and PDAC diagnosis are clinical entities widely overlapping with T2D. Therefore, the success of a strategy considering diabetes onset as a marker of asymptomatic PDAC will largely depend on our ability to identify new diabetes-unrelated biomarkers of PDAC.
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