评估胰腺癌高危人群监测计划中的葡萄糖和 HbA1c 监测。

IF 3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Clinical and Translational Gastroenterology Pub Date : 2024-10-16 DOI:10.14309/ctg.0000000000000777
Jihane Meziani, Jedidja G Y de Jong, Gwenny M Fuhler, Brechtje D M Koopmann, Iris J M Levink, Paul Fockens, Frank P Vleggaar, Marco J Bruno, Djuna L Cahen
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引用次数: 0

摘要

简介:多项研究表明,新发糖尿病(NOD)是胰腺导管腺癌(PDAC)的早期表现。因此,国际胰腺癌筛查(CAPS)联盟建议对接受监测的高危人群(HRIs)进行血糖和 HbA1c 监测。然而,目前还缺乏证据表明这种监测能提高 PDAC 的检测率。我们的目的是调查接受监测的高危人群中血清葡萄糖和 HbA1c 值与 PDAC 发展之间的关系:方法:参与者从家族性胰腺癌(FPC)监测队列中招募,该队列每年通过 MRI 和/或 EUS 以及血液采样对有遗传倾向的 HRI 进行跟踪。至少接受过一次空腹血糖和/或 HbA1c 监测的患者为合格候选者:结果:404 例 HRI 符合纳入标准。在中位 41 个月(14-120 个月)的随访期间,9 人发展为 PDAC,4 人(无 PDAC)被诊断为 NOD。血糖水平为 3.4-10.7 mmol/L(平均值为 5.6 ± 0.7),HbA1c 水平为 25-68 mmol/mol(平均值为 37.7 ± 4.1)。PDAC 病例与对照组的平均值无明显差异。PDAC 病例和对照组之间至少有一项数值升高的百分比相当,葡萄糖(33% 和 27%,P=0.707)和 HbA1c(22% 和 14%,P=0.623)。随着时间的推移,血糖或 HbA1c 的变化趋势与 PDAC 的发展并不一致:结论:在该 HRI 监测队列中,测量血糖和 HbA1c 值无助于 PDAC 的检测。要确定血糖和 HbA1c 监测在 PDAC 监测中的最终作用,还需要进行更大规模和更长期的研究。
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Assessment of Glucose and HbA1c Monitoring in a Pancreatic Cancer Surveillance Program for High-Risk Individuals.

Introduction: Several studies suggest that new-onset diabetes mellitus is an early manifestation of pancreatic ductal adenocarcinoma (PDAC). Therefore, the International Cancer of the Pancreas Screening Consortium recommends glucose and hemoglobin A1c (HbA1c) monitoring in high-risk individuals (HRIs) undergoing surveillance. However, evidence that such monitoring improves PDAC detection is lacking. Our aim was to investigate the association between serum glucose and HbA1c values and the development of PDAC in HRIs undergoing surveillance.

Methods: Participants were recruited from the familial pancreatic cancer surveillance cohort, which follows hereditary predisposed HRIs yearly by magnetic resonance imaging and/or endoscopic ultrasound and blood sampling. Those who underwent fasting glucose and/or HbA1c monitoring at least once were eligible candidates.

Results: Four hundred four HRIs met the inclusion criteria. During a median follow-up of 41 months (range 14-120), 9 individuals developed PDAC and 4 (without PDAC) were diagnosed with new-onset diabetes mellitus. Glucose levels ranged from 3.4 to 10.7 mmol/L (mean 5.6 ± 0.7) and HbA1c levels from 25 to 68 mmol/mol (mean 37.7 ± 4.1). The mean values did not differ significantly between PDAC cases and controls. The percentage of individuals with at least one elevated value were comparable between PDAC cases and controls for glucose (33% and 27%, P = 0.707) and HbA1c (22% and 14%, P = 0.623). No consistent glucose or HbA1c trends over time suggested a correlation with PDAC development.

Discussion: In this HRI surveillance cohort, measuring glucose and HbA1c values did not contribute to PDAC detection. Larger and longer-term studies are needed to determine the final role of glucose and HbA1c monitoring in PDAC surveillance.

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来源期刊
Clinical and Translational Gastroenterology
Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
7.00
自引率
0.00%
发文量
114
审稿时长
16 weeks
期刊介绍: Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.
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