AUTHOR=Yang Jie , Zhang Jia , Wang Rui , Liu Ya , Chen Yonghua 

TITLE=Prevalence of dysglycemia and associated risk factors in patients with pancreatic benign and low-grade malignant tumors before pancreatic surgery: A prospective observational study

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.960843

DOI=10.3389/fendo.2022.960843

ISSN=1664-2392

ABSTRACT=Background
Pancreatic benign and low-grade malignant tumors (PBLMT) worldwide acknowledged a rapid growth in incidence rate. Few studies had focused on the status of glucose metabolism of PBLMT patients before pancreatic surgery.
Methods
From August 2017 to June 2018, 80 patients with suspected PBLMT were prospectively screened for abnormalities in glucose metabolism before pancreatic surgery. After the exclusion, 70 participants were included for analysis. Patients were classified as normal glucose tolerance (NGT), prediabetes mellitus (Pre-DM), or new-onset DM (NOD) according to the American Diabetes Association (ADA) criterion. Indices of β cell function and insulin sensitivity were calculated. Tumor volume and remnant pancreatic volume (RPV) was calculated by computer tomography.
Results
Of the 70 patients with PBLMT, 49 patients had a pre-DM or NOD. RPV was 18.5% smaller in pre-DM patients (57.44 ± 18.20 cm3 vs. 70.48 ± 14.08 cm3, P = 0.001) and 46.9% smaller in NOD patients (37.38 ± 20.40 cm3 vs. 70.48 ± 14.08 cm3, P＜0.001) compared with NG patients. Compared with the pre-DM group, patients with NOD still showed smaller RPV (P＜0.001). Among the glucose metabolism indices, β cell dysfunction was strongly associated with PBLMT patients with pre-DM and NOD. After univariate and multivariate analysis, PBLMT patients with ages over 60 years (P = 0.049, OR = 5.76, 95%CI: 1.01-32.92) and RPV less than 49.36 cm3 (P = 0.024, OR = 8.59, 95%CI: 1.34-55.22) showed independent risk factors for dysglycemia respectively. The analysis of the entire patients revealed inverse correlations between RPV and both in age (r = -0.28, P = 0.019) and tumor volume (r = -0.28, P = 0.032). Positive correlations were found between RPV and both insulinogenic index (r = 0.29, P = 0.019) and insulin secretion/insulin resistance index (r = 0.39, P = 0.0011).
Conclusion
In patients with PBLMT, 70% had dysglycemia (pre-DM or NOD) before surgery. PBLMT patients over 60 years old and RPV less than 49.36 cm3 were independent risk factors for developing dysglycemia.