New insights into pancreatic cancer-induced paraneoplastic diabetes.
New insights into pancreatic cancer-induced paraneoplastic diabetes.
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DOI：
10.1038/nrgastro.2013.49
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发表时间：
2013-07
期刊：
影响因子：
--
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高达85%的胰腺癌患者患有糖尿病或高血糖症，通常早在胰腺癌诊断前2-3年就表现出来。相反，新发糖尿病患者在发生糖尿病的1-3年内被诊断为胰腺癌的风险增加5-8倍。新的证据表明胰腺癌会导致糖尿病。与2型糖尿病一样，在胰腺癌诱导的糖尿病中观察到β细胞功能障碍和外周胰岛素抵抗。然而，与2型糖尿病患者不同的是，胰腺癌患者面临持续的，通常是深刻的体重减轻，葡萄糖控制使其陷入困境。糖尿病和体重减轻是胰腺癌引起的副肿瘤现象，在恶病质发作前数月出现。虽然这些胰腺癌诱导的代谢改变的发病机制才刚刚开始被理解，但这些可能是促进胰腺癌在敌对和高度促纤维增生的微环境中生存和生长的机制。有趣的是，这些代谢变化可以使胰腺癌的早期诊断成为可能，如果它们可以与2型糖尿病患者中发生的代谢变化区分开来的话。一种可能的生物标志物是肾上腺髓质素，它是胰腺癌诱导的糖尿病中β细胞功能障碍的潜在介质。
Up to 85% of patients with pancreatic cancer have diabetes or hyperglycaemia, which frequently manifests as early as 2–3 years before a diagnosis of pancreatic cancer. Conversely, patients with new-onset diabetes have a 5–8-fold increased risk of being diagnosed with pancreatic cancer within 1–3 years of developing diabetes. Emerging evidence now indicates that pancreatic cancer causes diabetes. As in type 2 diabetes, β-cell dysfunction and peripheral insulin resistance are seen in pancreatic cancer-induced diabetes. However, unlike in patients with type 2 diabetes, glucose control worsens in patients with pancreatic cancer in the face of ongoing, often profound, weight loss. Diabetes and weight loss, which precede cachexia onset by several months, are paraneoplastic phenomena induced by pancreatic cancer. Although the pathogenesis of these pancreatic cancer-induced metabolic alterations is only beginning to be understood, these are likely mechanisms to promote the survival and growth of pancreatic cancer in a hostile and highly desmoplastic microenvironment. Interestingly, these metabolic changes could enable early diagnosis of pancreatic cancer, if they can be distinguished from the ones that occur in patients with type 2 diabetes. One such possible biomarker is adrenomedullin, which is a potential mediator of β-cell dysfunction in pancreatic cancer-induced diabetes.
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影响因子：
8.2
作者：
Butler, A. E.;Galasso, R.;Matveyenko, A.;Rizza, R. A.;Dry, S.;Butler, P. C.
通讯作者：
Butler, P. C.
影响因子：
29.4
作者：
Aggarwal G;Ramachandran V;Javeed N;Arumugam T;Dutta S;Klee GG;Klee EW;Smyrk TC;Bamlet W;Han JJ;Rumie Vittar NB;de Andrade M;Mukhopadhyay D;Petersen GM;Fernandez-Zapico ME;Logsdon CD;Chari ST
通讯作者：
Chari ST
DOI：
10.1016/j.pan.2012.02.003
发表时间：
2012-03
期刊：
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
影响因子：
--
作者：
Aggarwal G;Rabe KG;Petersen GM;Chari ST
通讯作者：
Chari ST
DOI：
10.1073/pnas.1203339109
发表时间：
2012-08-21
影响因子：
11.1
作者：
Chaika, Nina V.;Gebregiworgis, Teklab;Singh, Pankaj K.
通讯作者：
Singh, Pankaj K.
DOI：
10.1007/bf02576207
发表时间：
1993-02-01
期刊：
RESEARCH IN EXPERIMENTAL MEDICINE
影响因子：
--
作者：
AHREN, B;ANDRENSANDBERG, A
通讯作者：
ANDRENSANDBERG, A