Pancreatic cancer-associated diabetes mellitus is characterized by reduced β-cell secretory capacity, rather than insulin resistance
Pancreatic cancer-associated diabetes mellitus is characterized by reduced β-cell secretory capacity, rather than insulin resistance
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DOI：
10.1016/j.diabres.2022.109223
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发表时间：
2022-02-24
影响因子：
5.1
通讯作者：
Li, Ling
中科院分区：
文献类型：
--
作者：
Bao, Jiantong;Liu, Dechen;Li, Ling
目的：早期鉴别老年糖尿病患者胰腺癌相关性糖尿病（PaCDM）是至关重要的。然而，PaCDM和2型糖尿病（T2DM）仍然无法区分。我们的目的是研究PaCDM和T2DM患者胰腺和肠道内分泌激素的差异。方法：对44名受试者进行混合膳食耐受试验（MMTT）。测定空腹和餐后胰岛素、c肽、胰高血糖素、胰多肽（PP）、胰高血糖素样肽-1 （GLP-1）和胃抑制肽（GIP）的浓度。计算胰岛素敏感性和分泌指数。采用单因素方差分析和事后分析进行统计分析。结果：与T2DM患者相比，PaCDM患者对MMTT的胰岛素和c肽反应减弱。基线浓度和auc不同。PaCDM患者胰岛素分泌能力较T2DM患者低，但胰岛素敏感性较T2DM患者高。T2DM组PP峰值浓度和AUC均高于健康对照组，但与PaCDM一致。PaCDM患者GLP-1基线浓度低于T2DM患者。胰高血糖素和GIP组间无差异。结论：PaCDM患者的基线及餐后胰岛素和c肽分泌均低于T2DM患者。与T2DM患者相比，PaCDM患者胰岛素分泌减少，外周敏感性提高。
Aims: The early distinction of pancreatic cancer associated diabetes (PaCDM) in patients with elderly diabetes is critical. However, PaCDM and type 2 diabetes mellitus (T2DM) remain indistinguishable. We aim to address the differences between the pancreatic and gut endocrine hormones of patients with PaCDM and T2DM.Methods: A total of 44 participants underwent mixed meal tolerance test (MMTT). Fasting and postprandial concentrations of insulin, C-peptide, glucagon, pancreatic polypeptide (PP), glucagon-like peptide-1 (GLP-1), and gastric inhibitory peptide (GIP) were measured. Insulin sensitivity and secretion indices were calculated. One-way ANOVA with post-hoc analysis was used for statistical analysis.Results: Insulin and C-peptide responses to MMTT were blunted in PaCDM patients compared with T2DM. Baseline concentrations and AUCs differed. PaCDM patients showed lower insulin secretion capacity but better insulin sensitivity than T2DM patients. The peak concentration and AUC of PP in T2DM group were higher than healthy controls, but in accordance with PaCDM. PaCDM patients presented lower baseline GLP-1 concentration than T2DM patients. No between-group differences were found for glucagon and GIP.Conclusions: PaCDM patients had a lower baseline and postprandial insulin and C-peptide secretion than T2DM patients. Reduced insulin secretion and improved peripheral sensitivity were found in PaCDM patients compared with T2DM.