Department of Internal Medicine, Mayo Clinic, Rochester, MN55905, USA.
Pancreas. 2011 Jul;40(5):768-72. doi: 10.1097/MPA.0b013e318220816a.
New-onset diabetes mellitus (DM) may herald pancreatic cancer (PaC). We determined whether changes in body weight distinguished PaC-associated DM (PaCDM) from type 2 DM.
Among Olmsted County residents, we identified 29 PaCDM and 43 type 2 DM subjects who had serial fasting blood glucose measurements, new-onset DM, and no cancer-specific symptoms at DM onset. We compared body weight (kg) and fasting blood glucose (mg/dL) at DM onset, 1 to 2 years before and at index date in the 2 groups.
Fasting blood glucose values were similar before and at the onset of DM. Before onset of DM, PaCDM and type 2 DM subjects had similar body weight (P = 0.80). However, at onset of DM, 59% of PaCDM subjects lost weight versus 30% of type 2 DM subjects (P = 0.02). At onset of DM, 56% of type 2 DM subjects gained weight versus 31% of PaCDM subjects (P = 0.04). By index date, PaCDM subjects lost more weight than type 2 DM subjects did (8.3 ± 8.3 vs 0.8 ± 4.8 kg, P < 0.01).
Although new-onset primary type 2 DM is typically associated with weight gain, weight loss frequently precedes onset of PaCDM. The paradoxical development of diabetes in the face of ongoing weight loss may be an important clue to understanding the pathogenesis of PaCDM.
新发糖尿病（DM）可能预示着胰腺癌（PaC）的发生。我们旨在确定体重变化是否能区分与 PaC 相关的糖尿病（PaCDM）与 2 型糖尿病。
在奥姆斯特德县的居民中，我们确定了 29 名 PaCDM 和 43 名 2 型糖尿病患者，他们有连续的空腹血糖测量值、新发糖尿病且在糖尿病发病时没有癌症特异性症状。我们比较了两组患者在糖尿病发病时、发病前 1 年至 2 年及在发病时的体重（kg）和空腹血糖（mg/dL）。
空腹血糖值在糖尿病发病前后相似。在糖尿病发病前，PaCDM 和 2 型糖尿病患者的体重相似（P = 0.80）。然而，在糖尿病发病时，59%的 PaCDM 患者体重减轻，而 30%的 2 型糖尿病患者体重增加（P = 0.02）。在糖尿病发病时，56%的 2 型糖尿病患者体重增加，而 31%的 PaCDM 患者体重增加（P = 0.04）。到发病时，PaCDM 患者比 2 型糖尿病患者体重减轻更多（8.3 ± 8.3 比 0.8 ± 4.8kg，P < 0.01）。
尽管新发原发性 2 型糖尿病通常与体重增加相关，但体重减轻常先于 PaCDM 的发病。在持续体重减轻的情况下出现糖尿病的矛盾发展可能是理解 PaCDM 发病机制的重要线索。
