Glycemic Abnormalities in Pancreatic Cystic Lesions—A Single-Center Retrospective Analysis

Gastroenterology Insights

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Daniel Vasile Balaban¹  Laura Coman¹  Marina Balaban¹  Andreea Zoican¹  Danusia Adriana Pușcașu¹  Simin Ayatollahi¹  Emanuela Mihălțeanu¹  Raluca Simona Costache¹  Florentina Ioniță-Radu¹  Mariana Jinga¹ 

[1] Internal Medicine and Gastroenterology Department, Carol Davila University of Medicine and Pharmacy;Gastroenterology Department, Central Military Emergency University Hospital

关键词: diabetes;    new-onset diabetes;    pancreatic cysts;    cancer;   

DOI  :  10.3390/gastroent14020015

学科分类：地球科学(综合)

来源: mdpi

【 摘 要 】

Background and Objectives: Glucose metabolism alterations are very common in solid pancreatic lesions, particularly in pancreatic cancer. Similarly, diabetes and especially new-onset diabetes (NOD) have been associated with the malignant transformation of pancreatic cysts. We aimed to assess the prevalence and relevant associations of glycemic abnormalities in pancreatic cystic lesions (PCLs) in a retrospective analysis. Materials and Methods: We retrospectively recruited all patients who underwent endoscopic ultrasound for a PCL over a period of 36 months (January 2018 to December 2021). Final diagnosis was set by means of tissue acquisition, surgery, follow-up, or board decision. Demographic and clinical data, laboratory workup, and imaging features were extracted from the patients’ charts according to a predefined protocol. We considered fasting blood glucose (FBG) and HbA1c values and stratified the patients as nondiabetic (FBG ≤ 99 mg/dL, HbA1c ≤ 5.6%, no history of glycemic abnormalities), prediabetic (FBG 100–125 mg/dL, HbA1c 5.7–6.4%), or diabetic (long-lasting diabetes or NOD). Results: Altogether, 81 patients were included, with a median age of 66 years, and 54.3% of them were male. The overall prevalence of fasting hyperglycemia was 54.3%, comprising 34.6% prediabetes and 22.2% diabetes, of which 16.7% had NOD. The mean FBG and HbA1c levels were higher in malignant and premalignant PCLs (intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), cystadenocarcinoma, and cystic neuroendocrine tumor) compared to the benign lesions (pseudocysts, walled-off necrosis, and serous cystadenoma): 117.0 mg/dL vs. 108.3 mg/dL and 6.1% vs. 5.5%, respectively. Conclusions: Hyperglycemia and diabetes are common in PCLs, with a high prevalence in premalignant and malignant cysts. Screening and follow-up for glycemic abnormalities should be routinely conducted for PCLs, as they can contribute to a tailored risk assessment of cysts.

【 授权许可】

CC BY