Department of Endocrinology and Metabolism, Shanghai University of Medicine & Health Sciences Affiliated Fengxian Hospital, 6600 Nanfeng Road, Shanghai 201499, China.
Department of Comprehensive Diagnosis and Treatment for Diabetes, Shanghai University of Medicine & Health Sciences Affiliated Fengxian Hospital, 6600 Nanfeng Road, Shanghai 201499, China.
J Diabetes Res. 2019 Aug 5;2019:6371231. doi: 10.1155/2019/6371231. eCollection 2019.
To examine pancreatic volume (PV) changes among patients with different duration of type 2 diabetes and whether pancreatic atrophy was associated with loss of insulin secretory capacity.
This cross-sectional study (203 patients with type 2 diabetes, 93 controls without diabetes) was conducted from January 2016 to December 2017. Patients with type 2 diabetes were divided into 3 groups: recently diagnosed (duration ≤ 2 years), midterm (duration 3-9 years), and long term (duration ≥ 10 years). All the patients were scanned with upper abdominal computerized tomography; PV was then calculated by an experienced technician. Absolute insulin deficiency was defined as fasting C - peptide < 0.9 ng/mL.
Compared with PV (cm) in the controls, the mean PV was similar in patients with recently diagnosed type 2 diabetes (68.8 versus 71.0, = 0.56) but significantly reduced in patients with midterm (68.8 versus 60.8, < 0.05) and long-term (68.8 versus 53.1, < 0.001) type 2 diabetes. A similar trend was observed for the PV index (PV adjusted for body surface area and body mass index). Furthermore, rates of pancreatic atrophy and absolute insulin deficiency increased with duration of diabetes. Multiple logistic regression analysis indicated that pancreatic atrophy was associated with higher likelihood of absolute insulin deficiency (odds ratio = 4.47, 95%confidence interval = 1.45-13.8).
PV was reduced in those with midterm and long-term type 2 diabetes compared to individuals without type 2 diabetes. Overall, pancreatic atrophy was associated with the loss of insulin secretory capacity in patients with type 2 diabetes.
研究不同病程 2 型糖尿病患者的胰腺体积（PV）变化，以及胰腺萎缩是否与胰岛素分泌能力丧失有关。
本横断面研究（203 例 2 型糖尿病患者，93 例无糖尿病对照者）于 2016 年 1 月至 2017 年 12 月进行。2 型糖尿病患者分为 3 组：近期诊断（病程≤2 年）、中期（病程 3-9 年）和长期（病程≥10 年）。所有患者均行上腹部计算机断层扫描；由经验丰富的技术员计算 PV。空腹 C 肽<0.9ng/mL 定义为绝对胰岛素缺乏。
与对照组相比，近期诊断的 2 型糖尿病患者的平均 PV（cm）相似（68.8 比 71.0，=0.56），但中期（68.8 比 60.8，<0.05）和长期（68.8 比 53.1，<0.001）2 型糖尿病患者的 PV 明显降低。PV 指数（PV 按体表面积和体重指数校正）也出现类似趋势。此外，随着糖尿病病程的延长，胰腺萎缩和绝对胰岛素缺乏的发生率增加。多因素逻辑回归分析表明，胰腺萎缩与绝对胰岛素缺乏的可能性更大相关（比值比=4.47，95%置信区间=1.45-13.8）。
与无 2 型糖尿病者相比，中期和长期 2 型糖尿病患者的 PV 降低。总体而言，胰腺萎缩与 2 型糖尿病患者胰岛素分泌能力丧失有关。
