{"title":"缓慢进展型1型糖尿病和女性作为胰腺异常的相关因素在诊断影像学上显示癌前病变的可能性。","authors":"Tomoyasu Fukui, Tetsuro Kobayashi, Takuya Awata, Hiroshi Ikegami, Akihisa Imagawa, Yoichi Oikawa, Haruhiko Osawa, Eiji Kawasaki, Masanari Kuwabara, Kazuhiko Kobayashi, Takeshi Katsuki, Norio Kanatsuna, Junji Kozawa, Noriko Kodani, Akira Shimada, Masayuki Shimoda, Kazuma Takahashi, Daisuke Chujo, Tetsuro Tsujimoto, Kyoichiro Tsuchiya, Jungo Terasaki, Kan Nagasawa, Shinsuke Noso, Ichiro Horie, Kazuki Yasuda, Hisafumi Yasuda, Toshiaki Hanafusa, Hiroshi Kajio","doi":"10.1136/bmjdrc-2025-005229","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to identify factors associated with pancreatic abnormal findings on imaging (PAI) suggesting precancerous potential between slowly progressive type 1 diabetes and acute-onset type 1 diabetes.</p><p><strong>Research design and methods: </strong>The study was designed to identify factors associated with PAI using data from a nationwide cohort, the Japanese Type 1 Diabetes Database. Clinical factors, including sex, age, type of diabetes onset, diabetes duration, body mass index, and human leucocyte antigen genotypes associated with type 1 diabetes, were evaluated.</p><p><strong>Results: </strong>Among 279 patients with type 1 diabetes, 95 patients who had not undergone imaging evaluations, two patients with pancreatic lipomatosis, and 15 patients with missing data were excluded. Finally, a total of 167 patients with type 1 diabetes were analyzed. Among 13 patients who were identified as PAI positive, female sex (92.3% vs 53.2%, p=0.007), slowly progressive type 1 diabetes (69.2% vs 36.4%, p=0.034), and older age were more common compared with PAI-negative cases. The multivariable logistic regression analysis revealed that female sex (OR 13.87; 95% CI 1.6 to 120.1; p=0.017), slowly progressive type 1 diabetes (OR 5.70; 95% CI 1.46 to 22.19; p=0.012), and age (OR 1.05; 95% CI 1.002 to 1.103; p=0.043) were independently associated with PAI positivity.</p><p><strong>Conclusions: </strong>The findings indicate that slowly progressive type 1 diabetes and female sex are closely associated with PAI, along with age. These results suggest the need for increased clinical vigilance for pancreatic pathology in patients with slowly progressive type 1 diabetes.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 5","pages":""},"PeriodicalIF":4.1000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439140/pdf/","citationCount":"0","resultStr":"{\"title\":\"Slowly progressive type 1 diabetes and female sex as associated factors for pancreatic abnormalities on diagnostic imaging indicating precancerous potential.\",\"authors\":\"Tomoyasu Fukui, Tetsuro Kobayashi, Takuya Awata, Hiroshi Ikegami, Akihisa Imagawa, Yoichi Oikawa, Haruhiko Osawa, Eiji Kawasaki, Masanari Kuwabara, Kazuhiko Kobayashi, Takeshi Katsuki, Norio Kanatsuna, Junji Kozawa, Noriko Kodani, Akira Shimada, Masayuki Shimoda, Kazuma Takahashi, Daisuke Chujo, Tetsuro Tsujimoto, Kyoichiro Tsuchiya, Jungo Terasaki, Kan Nagasawa, Shinsuke Noso, Ichiro Horie, Kazuki Yasuda, Hisafumi Yasuda, Toshiaki Hanafusa, Hiroshi Kajio\",\"doi\":\"10.1136/bmjdrc-2025-005229\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>This study aimed to identify factors associated with pancreatic abnormal findings on imaging (PAI) suggesting precancerous potential between slowly progressive type 1 diabetes and acute-onset type 1 diabetes.</p><p><strong>Research design and methods: </strong>The study was designed to identify factors associated with PAI using data from a nationwide cohort, the Japanese Type 1 Diabetes Database. Clinical factors, including sex, age, type of diabetes onset, diabetes duration, body mass index, and human leucocyte antigen genotypes associated with type 1 diabetes, were evaluated.</p><p><strong>Results: </strong>Among 279 patients with type 1 diabetes, 95 patients who had not undergone imaging evaluations, two patients with pancreatic lipomatosis, and 15 patients with missing data were excluded. Finally, a total of 167 patients with type 1 diabetes were analyzed. Among 13 patients who were identified as PAI positive, female sex (92.3% vs 53.2%, p=0.007), slowly progressive type 1 diabetes (69.2% vs 36.4%, p=0.034), and older age were more common compared with PAI-negative cases. The multivariable logistic regression analysis revealed that female sex (OR 13.87; 95% CI 1.6 to 120.1; p=0.017), slowly progressive type 1 diabetes (OR 5.70; 95% CI 1.46 to 22.19; p=0.012), and age (OR 1.05; 95% CI 1.002 to 1.103; p=0.043) were independently associated with PAI positivity.</p><p><strong>Conclusions: </strong>The findings indicate that slowly progressive type 1 diabetes and female sex are closely associated with PAI, along with age. 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引用次数: 0
摘要
本研究旨在确定胰腺影像学异常(PAI)相关因素,提示缓慢进展型1型糖尿病和急性发作型1型糖尿病之间存在癌前病变的可能性。研究设计和方法:本研究旨在利用日本1型糖尿病数据库的全国性队列数据,确定与PAI相关的因素。评估临床因素,包括性别、年龄、糖尿病发病类型、糖尿病病程、体重指数和与1型糖尿病相关的人白细胞抗原基因型。结果:279例1型糖尿病患者中,排除了95例未接受影像学评估的患者、2例胰腺脂肪变性患者和15例数据缺失患者。最后,对167例1型糖尿病患者进行分析。在PAI阳性的13例患者中,女性(92.3% vs 53.2%, p=0.007)、缓慢进展型1型糖尿病(69.2% vs 36.4%, p=0.034)、年龄较PAI阴性患者更为常见。多变量logistic回归分析显示,女性(OR 13.87; 95% CI 1.6 ~ 120.1; p=0.017)、缓慢进展型1型糖尿病(OR 5.70; 95% CI 1.46 ~ 22.19; p=0.012)和年龄(OR 1.05; 95% CI 1.002 ~ 1.103; p=0.043)与PAI阳性独立相关。结论:研究结果提示,缓慢进展型1型糖尿病、女性与PAI密切相关,且与年龄相关。这些结果提示需要提高临床对缓慢进展型1型糖尿病患者胰腺病理的警惕性。
Slowly progressive type 1 diabetes and female sex as associated factors for pancreatic abnormalities on diagnostic imaging indicating precancerous potential.
Introduction: This study aimed to identify factors associated with pancreatic abnormal findings on imaging (PAI) suggesting precancerous potential between slowly progressive type 1 diabetes and acute-onset type 1 diabetes.
Research design and methods: The study was designed to identify factors associated with PAI using data from a nationwide cohort, the Japanese Type 1 Diabetes Database. Clinical factors, including sex, age, type of diabetes onset, diabetes duration, body mass index, and human leucocyte antigen genotypes associated with type 1 diabetes, were evaluated.
Results: Among 279 patients with type 1 diabetes, 95 patients who had not undergone imaging evaluations, two patients with pancreatic lipomatosis, and 15 patients with missing data were excluded. Finally, a total of 167 patients with type 1 diabetes were analyzed. Among 13 patients who were identified as PAI positive, female sex (92.3% vs 53.2%, p=0.007), slowly progressive type 1 diabetes (69.2% vs 36.4%, p=0.034), and older age were more common compared with PAI-negative cases. The multivariable logistic regression analysis revealed that female sex (OR 13.87; 95% CI 1.6 to 120.1; p=0.017), slowly progressive type 1 diabetes (OR 5.70; 95% CI 1.46 to 22.19; p=0.012), and age (OR 1.05; 95% CI 1.002 to 1.103; p=0.043) were independently associated with PAI positivity.
Conclusions: The findings indicate that slowly progressive type 1 diabetes and female sex are closely associated with PAI, along with age. These results suggest the need for increased clinical vigilance for pancreatic pathology in patients with slowly progressive type 1 diabetes.
期刊介绍:
BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of
high-quality — and evidence-based — original research articles.