Assessing the Pathophysiology of Hyperglycemia in the Diabetes RElated to Acute Pancreatitis and Its Mechanisms Study: From the Type 1 Diabetes in Acute Pancreatitis Consortium.
Assessing the Pathophysiology of Hyperglycemia in the Diabetes RElated to Acute Pancreatitis and Its Mechanisms Study: From the Type 1 Diabetes in Acute Pancreatitis Consortium.
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DOI：
10.1097/mpa.0000000000002074
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发表时间：
2022-07-01
期刊：
影响因子：
2.9
通讯作者：
Toledo, Frederico G. S.
中科院分区：
文献类型：
--
作者：
Dungan, Kathleen M.;Hart, Phil A.;Andersen, Dana K.;Basina, Marina;Chinchilli, Vernon M.;Danielson, Kirstie K.;Evans-Molina, Carmella;Goodarzi, Mark O.;Greenbaum, Carla J.;Kalyani, Rita R.;Laughlin, Maren R.;Pichardo-Lowden, Ariana;Pratley, Richard E.;Serrano, Jose;Sims, Emily K.;Speake, Cate;Yadav, Dhiraj;Bellin, Melena D.;Toledo, Frederico G. S.
关键词：
急性胰腺炎（AP）发作后导致糖尿病（DM）的代谢异常尚未得到广泛研究。本文描述了葡萄糖代谢机制研究的目的、假设和方法，包括糖尿病与急性胰腺炎及其机制（DREAM）研究的次要结果。在AP指数发作3个月后，没有糖尿病的参与者将接受口服葡萄糖耐量试验的基线测试。参与者将被纵向分为三个亚队列，进行不同的代谢测试。在第一个也是最大的亚队列中，口服葡萄糖耐量试验将在AP后12个月重复进行，并每年进行一次，以评估β细胞功能、胰岛素分泌和胰岛素敏感性的变化。在第二项研究中，混合膳食耐受性试验将在3个月和12个月进行，然后每年进行一次，并在发生糖尿病后进行，以评估肠促胰岛素和胰多肽的反应。第三，将在3个月和12个月时进行频繁采样的静脉葡萄糖耐量试验，以评估第一阶段胰岛素反应，并更精确地测量β细胞功能和胰岛素敏感性。DREAM研究将全面评估AP术后DM发生前和导致DM发生的代谢和内分泌变化。
The metabolic abnormalities that lead to diabetes mellitus (DM) following an episode of acute pancreatitis (AP) have not been extensively studied. This manuscript describes the objectives, hypotheses, and methods of mechanistic studies of glucose metabolism that comprise secondary outcomes of the Diabetes RElated to Acute pancreatitis and its Mechanisms (DREAM) Study. Three months after an index episode of AP, participants without pre-existing DM will undergo baseline testing with an oral glucose tolerance test. Participants will be followed longitudinally in three sub-cohorts with distinct metabolic tests. In the first and largest subcohort, oral glucose tolerance tests will be repeated 12 months after AP and annually to assess changes in β-cell function, insulin secretion, and insulin sensitivity. In the second, mixed meal tolerance tests will be performed at 3 and 12 months, then annually, and following incident DM to assess incretin and pancreatic polypeptide responses. In the third, frequently-sampled intravenous glucose tolerance tests will be performed at 3 months and 12 months to assess the first-phase insulin response and more precisely measure β-cell function and insulin sensitivity. The DREAM study will comprehensively assess the metabolic and endocrine changes that precede and lead to the development of DM after AP.