Donovan Ashley L, Furlan Alessandro, Borhani Amir A, Kalor Ashley, Wang Li, Epelboym Rossmer Irene, Marsh J Wallis
Department of Surgery, The Ohio State University, Columbus, OH, USA.
Department of Radiology, University of Pittsburgh Medical Center, UPMC Presbyterian Campus, 200 Lothrop Street, Pittsburgh, PA, 15213, USA.
Abdom Radiol (NY). 2021 Jun;46(6):2628-2636. doi: 10.1007/s00261-020-02943-3. Epub 2021 Jan 20.
To identify clinical and imaging biomarkers that can predict the new onset of diabetes mellitus (NODM) within 1 year of pancreatic resection.
A retrospective chart review was conducted of 426 non-diabetic patients who underwent a pancreaticoduodenectomy or distal pancreatectomy at the University of Pittsburgh Medical Center between 2006 and 2016. Clinical characteristics and the patient's diabetic status at 1-year post resection were collected from the EMR. Imaging biomarkers included hepatic and pancreatic fat replacement, pancreatic calcifications, pancreatic duct diameter, pancreatic volume and body composition. Univariate and multivariable analyses were performed to demonstrate any predictive biomarkers of diabetes occurrence within 1 year of pancreatic resection.
135/426 (31.7%) patients developed NODM. The only significant clinical predictor was older age (OR 1.02, 95% CI 1.002-1.039, p = 0.032). Imaging characteristics found to be significant included hepatic steatosis (OR 1.777, 95% CI 1.094-2.886, p = 0.02), larger reduction in pancreas volume (OR 0.989, 95% CI 0.979-0.999, p = 0.027), and greater preoperative visceral fat (OR 1.004, 95% CI 1.001-1.006, p = 0.001).
Age, presence of hepatic steatosis, change in pancreatic volume, and preoperative visceral fat are independent predictive biomarkers for NODM following pancreatic resection.
确定能够预测胰腺切除术后1年内新发糖尿病（NODM）的临床和影像学生物标志物。
对2006年至2016年间在匹兹堡大学医学中心接受胰十二指肠切除术或胰腺远端切除术的426例非糖尿病患者进行回顾性病历审查。从电子病历中收集临床特征和患者术后1年时的糖尿病状态。影像学生物标志物包括肝脏和胰腺脂肪替代、胰腺钙化、胰管直径、胰腺体积和身体成分。进行单因素和多因素分析以证明胰腺切除术后1年内糖尿病发生的任何预测性生物标志物。
135/426（31.7%）例患者发生了NODM。唯一显著的临床预测因素是年龄较大（OR 1.02，95%CI 1.002 - 1.039，p = 0.032）。发现具有显著意义的影像特征包括肝脂肪变性（OR 1.777，95%CI 1.094 - 2.886，p = 0.02）、胰腺体积更大幅度减小（OR 0.989，95%CI 0.979 - 0.999，p = 0.027）以及术前内脏脂肪更多（OR 1.004，95%CI 1.001 - 1.006，p = 0.001）。
年龄、肝脂肪变性的存在、胰腺体积变化和术前内脏脂肪是胰腺切除术后NODM的独立预测性生物标志物。
