Increased Serum Insulin Exposure Does Not Affect Age or Stage of Pancreatic Adenocarcinoma Diagnosis in Patients With Diabetes Mellitus.
Increased Serum Insulin Exposure Does Not Affect Age or Stage of Pancreatic Adenocarcinoma Diagnosis in Patients With Diabetes Mellitus.
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DOI：
10.1097/mpa.0000000000000439
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发表时间：
2016-02
期刊：
影响因子：
2.9
通讯作者：
Brand RE
中科院分区：
文献类型：
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作者：
Chao DT;Shah NH;Zeh HJ 3rd;Bahary N;Whitcomb DC;Brand RE
在考虑增加胰岛素水平的药物是否会加速胰腺癌（PC）的发展时，我们假设使用外源性胰岛素或胰岛素刺激药物的糖尿病（DM）PC患者应具有较早的诊断年龄或存在更晚期的疾病。从2003年6月1日至2012年5月31日入组我们PC登记研究的患者根据仅接受胰岛素、胰岛素刺激药物或胰岛素非依赖性药物治疗进行分层。在队列中分析PC诊断的年龄、PC分期以及DM和PC诊断之间的年数。122例DM患者（平均年龄：67.4 ± 10.2岁），仅胰岛素（n=40）、胰岛素刺激（n=11）、胰岛素非依赖（n=71）和非DM（n=321）队列中PC诊断的平均年龄分别为68.7 ± 10.5岁、69.6 ± 10.8岁、66.3 ± 9.7岁，65.5 ± 10.5岁。根据糖尿病治疗的持续时间或类型，PC诊断的年龄之间没有显着差异。PC分期与胰岛素暴露增加无相关性。使用PC诊断的平均年龄、PC分期或DM和PC诊断之间的持续时间的结果，增加胰岛素暴露的抗DM药物似乎不会加速PC的发展。
In considering whether medications that increase insulin levels accelerate pancreatic adenocarcinoma (PC) development, we hypothesized that PC patients with diabetes mellitus (DM) who used exogenous insulin or insulin-stimulating medications should have an earlier age of diagnosis or present with more advanced disease. Patients enrolled in our PC registry from 6/1/2003 to 5/31/2012 were stratified according to treatment solely with insulin, insulin-stimulating medications, or insulin-independent medications. Age of PC diagnosis, PC stage, and years between DM and PC diagnoses were analyzed among the cohorts. Of 122 DM patients (mean age: 67.4 ± 10.2 years), the mean age of PC diagnosis within the insulin-only (n=40), insulin-stimulating (n=11), insulin-independent (n=71), and non-DM (n=321) cohorts were 68.7 ± 10.5 years, 69.6 ± 10.8 years, 66.3 ± 9.7 years, and 65.5 ± 10.5 years, respectively. No significant difference among the age of PC diagnosis was observed based on duration or type of DM treatment. There was no correlation between PC stage and increased insulin exposure. Anti-DM medications that increase exposure to insulin do not appear to accelerate PC development using outcomes of mean age of PC diagnosis, PC stage, or duration between DM and PC diagnoses.