Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo, Japan.
Department of Diabetes and Endocrinology, University of Yamanashi Hospital, Yamanashi, Japan.
J Diabetes Investig. 2022 Aug;13(8):1387-1395. doi: 10.1111/jdi.13791. Epub 2022 Apr 12.
AIMS/INTRODUCTION: To investigate factors influencing glycemic control in diabetes mellitus complicated by autoimmune pancreatitis.
This retrospective cohort study investigated 33 patients with diabetes mellitus complicated by autoimmune pancreatitis who had received steroid therapy at Toranomon Hospital between January 1, 2011, and December 31, 2020. The course of glycemic control at 12 months after starting steroids was classified into three groups: Improved, Unchanged, or Worsened. Factors affecting these groups were investigated. Furthermore, we created two scores: (1) time of diabetes mellitus onset and baseline body mass index; (2) time of diabetes mellitus onset and baseline C-peptide index. Diabetes mellitus occurring at the same time as autoimmune pancreatitis, body mass index ≥22 kg/m , and C-peptide index ≥1.1 were each worth 1 point. Scores were summed and totals of 0-2 were compared between groups.
Ten patients were in the Improved group, 10 were in the Unchanged group, and 13 were in the Worsened group. The baseline body mass index and baseline C-peptide index were lower in the Worsened group than in the Improved group (P < 0.05 each). In addition, the scores were lower in the Worsened group than in the other groups (P < 0.05).
Patients with a lower baseline body mass index and a decreased baseline C-peptide index may experience worse glycemic control on steroid therapy.
目的/引言:研究影响糖尿病合并自身免疫性胰腺炎患者血糖控制的因素。
本回顾性队列研究纳入了 2011 年 1 月 1 日至 2020 年 12 月 31 日期间在本院接受类固醇治疗的 33 例糖尿病合并自身免疫性胰腺炎患者。根据开始使用类固醇后 12 个月的血糖控制情况,将其分为改善组、未变组和恶化组。分析影响血糖控制的因素。此外,我们创建了两个评分:(1)糖尿病发病时间和基线体重指数;(2)糖尿病发病时间和基线 C 肽指数。自身免疫性胰腺炎与糖尿病同时发病、体重指数≥22kg/m2 和 C 肽指数≥1.1 各计 1 分。对各分数进行累加,比较各组总分 0-2 分的情况。
10 例患者为改善组,10 例为未变组,13 例为恶化组。恶化组的基线体重指数和基线 C 肽指数低于改善组(均 P<0.05)。此外,恶化组的评分也低于其他两组(均 P<0.05)。
基线体重指数较低和基线 C 肽指数下降的患者在接受类固醇治疗时血糖控制可能更差。