基于人体测量学和代谢参数区分外分泌胰腺疾病相关糖尿病和2型糖尿病

IF 4.2 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2025-02-15 DOI:10.4239/wjd.v16.i2.95102

Anna Juza, Lilianna Kołodziej-Spirodek, Krzysztof Gutkowski, Mariusz Partyka, Mariusz Dąbrowski

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引用次数: 0

摘要

背景：成人发病的糖尿病通常被认为是2型糖尿病。然而，其他类型的糖尿病也可能在成人中发展，包括外分泌胰腺疾病相关糖尿病，也称为3c型糖尿病。鉴别诊断这些类型的糖尿病仍然是一个诊断挑战。目的：定义人体测量和实验室标记，以便早期诊断胰腺疾病相关糖尿病。方法：研究组纳入44例胰源性糖尿病患者（胰腺癌26例，慢性胰腺炎18例），对照组纳入35例2型糖尿病患者。我们分析了几个参数，包括性别、年龄、体重指数（BMI）、空腹血糖、空腹c肽和胰岛素，用稳态模型评估胰岛素抵抗（HOMA-IR）指数计算，肾上腺髓质素、脂联素和肌酐水平用表皮生长因子受体（eGFR）计算。我们还开发了一个称为3c型糖尿病指数的方程，该方程利用BMI、空腹胰岛素和肾上腺髓质素水平以及eGFR来更好地识别3c型糖尿病患者。结果：与2型糖尿病患者相比，胰源性糖尿病患者的BMI（25.11±4.87 kg/m2 vs 30.83±5.21 kg/m2）、空腹c肽（0.81±0.42 nmol/L vs 1.71±0.80 nmol/L）、胰岛素（76.81±63.34 pmol/L vs 233.19±164.51 pmol/L）和HOMA-IR指数均显著降低，尽管空腹血糖水平相似。胰源性糖尿病患者肾上腺髓质素水平也较低（0.41±0.25 ng/mL vs 0.63±0.38 ng/mL），但脂联素水平较高（13.08±7.20 μg/mL vs 8.28±4.01 μg/mL）， eGFR水平较高（100.53±21.60 mL/min/1.73 m2 vs 85.14±19.24 mL/min/1.73 m2）。最后，胰源性糖尿病患者的3c型糖尿病指数值明显降低。结论：胰源性糖尿病患者与2型糖尿病患者在人体测量和实验室参数上存在差异。3c型糖尿病指数的判别值最高，高于任何单一参数。

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Distinguishing exocrine pancreas disease-associated diabetes from type 2 diabetes based on anthropometric and metabolic parameters.

Background: Adult-onset diabetes is most often considered to be type 2 diabetes. However, other types of diabetes can develop in adults, including exocrine pancreas disease-associated diabetes, also called type 3c diabetes. Differential diagnosis between these types of diabetes still remains a diagnostic challenge.

Aim: To define anthropometric and laboratory markers that will allow for early diagnosis of pancreatic disease-associated diabetes.

Methods: The study group included 44 patients with pancreatogenic diabetes (26 with pancreatic cancer and 18 with chronic pancreatitis), while the control group consisted of 35 patients with type 2 diabetes. We analyzed several parameters, including sex, age, body mass index (BMI), fasting plasma glucose, fasting C-peptide and insulin with homeostasis model assessment of insulin resistance (HOMA-IR) index calculation, adrenomedullin, adiponectin and creatinine levels with epidermal growth factor receptor (eGFR) calculation. We also developed an equation, termed type 3c diabetes index, which utilized BMI, fasting insulin and adrenomedullin levels, and eGFR to better identify patients with type 3c diabetes.

Results: Compared to patients with type 2 diabetes, patients with pancreatogenic diabetes had significantly lower BMI (25.11 ± 4.87 kg/m² vs 30.83 ± 5.21 kg/m²), fasting C-peptide (0.81 ± 0.42 nmol/L vs 1.71 ± 0.80 nmol/L), insulin (76.81 ± 63.34 pmol/L vs 233.19 ± 164.51 pmol/L) and HOMA-IR index, despite similar fasting plasma glucose levels. Patients with pancreatogenic diabetes also had lower adrenomedullin levels (0.41 ± 0.25 ng/mL vs 0.63 ± 0.38 ng/mL) but higher adiponectin levels (13.08 ± 7.20 μg/mL vs 8.28 ± 4.01 μg/mL) and eGFR levels (100.53 ± 21.60 mL/min/1.73 m² vs 85.14 ± 19.24 mL/min/1.73 m²). Finally, patients with pancreatogenic diabetes had significantly lower Type 3c diabetes index values.

Conclusion: Patients with pancreatogenic diabetes differ from patients with type 2 diabetes in anthropometric and laboratory parameters. The type 3c diabetes index had the highest discriminating value, above any single parameter.

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.