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缓慢进展的1型糖尿病和女性性别作为诊断成像上胰腺异常的相关因素,提示有癌前潜能。

Slowly progressive type 1 diabetes and female sex as associated factors for pancreatic abnormalities on diagnostic imaging indicating precancerous potential.

作者信息

Fukui Tomoyasu, Kobayashi Tetsuro, Awata Takuya, Ikegami Hiroshi, Imagawa Akihisa, Oikawa Yoichi, Osawa Haruhiko, Kawasaki Eiji, Kuwabara Masanari, Kobayashi Kazuhiko, Katsuki Takeshi, Kanatsuna Norio, Kozawa Junji, Kodani Noriko, Shimada Akira, Shimoda Masayuki, Takahashi Kazuma, Chujo Daisuke, Tsujimoto Tetsuro, Tsuchiya Kyoichiro, Terasaki Jungo, Nagasawa Kan, Noso Shinsuke, Horie Ichiro, Yasuda Kazuki, Yasuda Hisafumi, Hanafusa Toshiaki, Kajio Hiroshi

机构信息

Division of Diabetes, Metabolism and Endocrinology, Department of Medicine, Showa Medical University, Tokyo, Japan

Seino Internal Medicine Clinic, Koriyama, Japan.

出版信息

BMJ Open Diabetes Res Care. 2025 Sep 15;13(5):e005229. doi: 10.1136/bmjdrc-2025-005229.

Abstract

INTRODUCTION

This study aimed to identify factors associated with pancreatic abnormal findings on imaging (PAI) suggesting precancerous potential between slowly progressive type 1 diabetes and acute-onset type 1 diabetes.

RESEARCH DESIGN AND METHODS

The study was designed to identify factors associated with PAI using data from a nationwide cohort, the Japanese Type 1 Diabetes Database. Clinical factors, including sex, age, type of diabetes onset, diabetes duration, body mass index, and human leucocyte antigen genotypes associated with type 1 diabetes, were evaluated.

RESULTS

Among 279 patients with type 1 diabetes, 95 patients who had not undergone imaging evaluations, two patients with pancreatic lipomatosis, and 15 patients with missing data were excluded. Finally, a total of 167 patients with type 1 diabetes were analyzed. Among 13 patients who were identified as PAI positive, female sex (92.3% vs 53.2%, p=0.007), slowly progressive type 1 diabetes (69.2% vs 36.4%, p=0.034), and older age were more common compared with PAI-negative cases. The multivariable logistic regression analysis revealed that female sex (OR 13.87; 95% CI 1.6 to 120.1; p=0.017), slowly progressive type 1 diabetes (OR 5.70; 95% CI 1.46 to 22.19; p=0.012), and age (OR 1.05; 95% CI 1.002 to 1.103; p=0.043) were independently associated with PAI positivity.

CONCLUSIONS

The findings indicate that slowly progressive type 1 diabetes and female sex are closely associated with PAI, along with age. These results suggest the need for increased clinical vigilance for pancreatic pathology in patients with slowly progressive type 1 diabetes.

摘要

引言

本研究旨在确定在缓慢进展型1型糖尿病和急性起病型1型糖尿病中,与提示癌前潜能的胰腺影像学异常表现(PAI)相关的因素。

研究设计与方法

本研究旨在利用来自全国性队列——日本1型糖尿病数据库的数据,确定与PAI相关的因素。对临床因素进行了评估,包括性别、年龄、糖尿病起病类型、糖尿病病程、体重指数以及与1型糖尿病相关的人类白细胞抗原基因型。

结果

在279例1型糖尿病患者中,排除了95例未接受影像学评估的患者、2例胰腺脂肪瘤患者以及15例数据缺失的患者。最终,共对167例1型糖尿病患者进行了分析。在被确定为PAI阳性的13例患者中,与PAI阴性病例相比,女性(92.3%对53.2%,p=0.007)、缓慢进展型1型糖尿病(69.2%对36.4%,p=0.034)以及年龄较大更为常见。多变量逻辑回归分析显示,女性(比值比13.87;95%置信区间1.6至120.1;p=0.017)、缓慢进展型1型糖尿病(比值比5.70;95%置信区间1.46至22.19;p=0.012)以及年龄(比值比1.05;95%置信区间1.002至1.103;p=0.043)与PAI阳性独立相关。

结论

研究结果表明,缓慢进展型1型糖尿病、女性以及年龄与PAI密切相关。这些结果提示,对于缓慢进展型1型糖尿病患者,需要提高对胰腺病变的临床警惕性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aea/12439140/6bec6f3b1331/bmjdrc-13-5-g001.jpg

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