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围手术期 C 肽指数与胰腺切除术后糖尿病管理状况相关。

Perioperative C-peptide index is associated with the status of diabetes management after pancreatectomy.

机构信息

First Department of Internal Medicine, University of Toyama, Toyama, Japan.

Center for Clinical Research, Toyama University Hospital, Toyama, Japan.

出版信息

J Diabetes Investig. 2022 Oct;13(10):1685-1694. doi: 10.1111/jdi.13861. Epub 2022 Jun 28.

Abstract

AIMS/INTRODUCTION: This study aimed to identify the clinical factors affecting postoperative residual pancreatic β-cell function, as assessed by the C-peptide index (CPI), and to investigate the association between perioperative CPI and the status of diabetes management after pancreatectomy.

MATERIALS AND METHODS

The associations between perioperative CPI and clinical background, including surgical procedures of pancreatectomy, were analyzed in 47 patients who underwent pancreatectomy, and were assessed for pre-and postoperative CPI. The association between perioperative CPI and glycemic control after pancreatectomy was investigated.

RESULTS

The low postoperative CPI group (CPI <0.7) had longer duration of diabetes (17.5 ± 14.5 vs 5.5 ± 11.0 years, P = 0.004), a higher percentage of sulfonylurea users (41.7 vs 8.7%, P = 0.003) and a greater number of drug categories used for diabetes treatment (1.9 ± 1.1 vs 0.8 ± 0.8, P <0.001) than did the high postoperative CPI group. Postoperative CPI was higher (1.4 ± 1.2 vs 0.7 ± 0.6, P = 0.039) in patients with low glycosylated hemoglobin (<7.0%) at 6 months after pancreatectomy; preoperative (2.0 ± 1.5 vs 0.7 ± 0.5, P = 0.012) and postoperative CPI (2.5 ± 1.4 vs 1.4 ± 1.1, P = 0.020) were higher in non-insulin users than in insulin users at 6 months after surgery.

CONCLUSIONS

The duration of diabetes and preoperative diabetes treatment were associated with residual pancreatic β-cell function after pancreatectomy. Furthermore, perioperative β-cell function as assessed by CPI was associated with diabetes management status after pancreatectomy.

摘要

目的/引言:本研究旨在确定影响术后残余胰岛β细胞功能的临床因素,以 C 肽指数(CPI)评估,并探讨围手术期 CPI 与胰腺切除术后糖尿病管理状况的关系。

材料和方法

对 47 例行胰腺切除术的患者进行分析,评估围手术期 CPI 与包括胰腺切除术手术方式在内的临床背景的关系,并对术前和术后 CPI 进行评估。研究了围手术期 CPI 与胰腺切除术后血糖控制的关系。

结果

低术后 CPI 组(CPI<0.7)糖尿病病程较长(17.5±14.5 年比 5.5±11.0 年,P=0.004),磺脲类药物使用者比例较高(41.7%比 8.7%,P=0.003),糖尿病治疗药物种类也较多(1.9±1.1 种比 0.8±0.8 种,P<0.001)。与高术后 CPI 组相比,术后 6 个月 CPI 较低(1.4±1.2 比 0.7±0.6,P=0.039),糖化血红蛋白<7.0%的患者;术后 6 个月时,未使用胰岛素的患者(2.0±1.5 比 0.7±0.5,P=0.012)和使用胰岛素的患者(2.5±1.4 比 1.4±1.1,P=0.020)的 CPI 较高。

结论

糖尿病病程和术前糖尿病治疗与胰腺切除术后残余胰岛β细胞功能有关。此外,CPI 评估的围手术期β细胞功能与胰腺切除术后糖尿病管理状况有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4659/9533048/9d817dea3f15/JDI-13-1685-g001.jpg

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