Bonner-Weir S, In't Veld P A, Weir G C
Joslin Diabetes Center, Department of Medicine, Harvard Medical School, Boston, MA, USA.
Diabetes Obes Metab. 2014 Jul;16(7):661-6. doi: 10.1111/dom.12257. Epub 2014 Jan 29.
A recently published study by Butler et al. concluded that incretin treatment had adverse effects on the human type 2 diabetic pancreas including 'a marked expansion of the exocrine and endocrine pancreatic compartments, the former being accompanied by increased proliferation and dysplasia and the latter by α-cell hyperplasia with the potential for evolution into neuroendocrine tumours'. Incretin therapy has become widely used for type 2 diabetes, so these conclusions have instigated major concerns with regard to patient safety. We reassessed both the clinical case information and virtual microscopy images of the same 34 cases that were used in the Butler study as well as Network for Pancreatic Organ Donation (nPOD) cases that were not included. Whereas we would like to stress that it is important to investigate in depth any indication that incretin treatment may lead to inflammation or dysplasia in the pancreas, we find that the data presented in the Butler paper have serious methodological deficiencies that preclude any meaningful conclusions.
巴特勒等人最近发表的一项研究得出结论，肠促胰岛素治疗对人类2型糖尿病胰腺有不良影响，包括“外分泌和内分泌胰腺区域显著扩大，前者伴有增殖增加和发育异常，后者伴有α细胞增生，有可能演变成神经内分泌肿瘤”。肠促胰岛素疗法已广泛用于2型糖尿病，因此这些结论引发了对患者安全的重大担忧。我们重新评估了巴特勒研究中使用的34例相同病例的临床病例信息和虚拟显微镜图像，以及未纳入的胰腺器官捐赠网络（nPOD）病例。虽然我们想强调，深入调查任何表明肠促胰岛素治疗可能导致胰腺炎症或发育异常的迹象很重要，但我们发现，巴特勒论文中呈现的数据存在严重的方法学缺陷，无法得出任何有意义的结论。
