Diabetes in Patients With Pancreatic Neuroendocrine Neoplasms

Abstract

ObjectiveDiabetes mellitus (DM) is probably a risk factor for pancreatic neuroendocrine neoplasms (PNENs). However, the prevalence of DM in PNEN patients remains inconclusive. In the present study we observed the prevalence of DM and possible risk factors in PNEN patients.MethodsAfter excluding those with insulinoma, a total of 197 patients with PNENs were included. The demographic data, pathological characteristics, and data of blood biochemical tests were recorded. DM was considered if there was evidence of a fasting plasma glucose level of ≥7.0 mmol/L or a 2-h plasma glucose level of ≥11.1 mmol/L, or a history of DM at the time of PNEN diagnosis. Impaired fasting glucose was considered if fasting plasma glucose level was between 6.1 and 7.0 mmol/L.ResultsThe prevalence of DM, new-onset DM, and impaired fasting glucose were 17.26, 9.14, and 7.1%, respectively. The prevalence of DM was 26.0% in patients ≥60 years old (19/73) and 12.1% in patients <60 years old. Multivariable logistic regression analysis demonstrated that age, tumor size, and nerve invasion were independent risk factors for DM and impaired fasting glucose + DM (p < 0.05). Age, organs and nerve invasion were independent risk factors for impaired fasting glucose. Low high-density lipoprotein (HDL) was also a risk factor for incident of DM (OR = 0.15, 95%CI: 0.03–0.66). G2/G3 was an independent risk factor for DM in women.ConclusionOur data shows that the prevalence of DM is 17.26% in patients with PNENs and is 26.0% in patients ≥60 years of age after excluding insulinoma. Age, nerve invasion, tumor size, and HDL are risk factors for DM in PNEN patients.

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

“…Both were higher than the overall prevalence of DM among adult Chinese individuals (35.7% and 10.9%, respectively) ( 18 ). When both fasting plasma glucose (FPG) and 2-hour postprandial plasma glucose were used to detect dysglycemia, the prevalence of NOD in PBLMT patients was comparable to that in PNET patients (9.4%) and IPMN patients (6%) in the previous studies ( 10 , 11 ). However, the prevalence of pre-DM in our study was more than seven times higher than that previously found in PNET patients (7.1%), which was assessed by preoperative FPG measurement only ( 10 ).…”

“…When both fasting plasma glucose (FPG) and 2-hour postprandial plasma glucose were used to detect dysglycemia, the prevalence of NOD in PBLMT patients was comparable to that in PNET patients (9.4%) andIPMN patients (6%) in the previous studies (10,11). However, the prevalence of pre-DM in our study was more than seven times higher than that previously found in PNET patients (7.1%), which was assessed by preoperative FPG measurement only (10). Indeed, more patients with prediabetes could be ignored by FPG alonethanbycombinedOGTT (19,20).Therefore,wethinkourstudy may reflect the actual dysglycemia status of PBLMT patients.…”

“…Indeed, few studies have focused on the glucose metabolism status of PBLMT patients. The prevalence of DM and impaired fasting glucose was 24.4% in PNET patients who did not receive medical treatment ( 10 ). Based on a meta-study, the prevalence of new-onset DM in IPMN patients was 6% (68 of 1,202) with a range of 1.5% to 29% ( 11 ).…”

Generation of an Obese Diabetic Mouse Model upon Conditional Atrx Disruption

“…The results obtained with our Atrx models interestingly suggest the potential role of ATRX in the homeostasis of human pancreatic endocrine function. T2D is a significant risk factor for PanNET development [65,66], but these patients are also at risk for T2D development [67,68]. An association between metabolic syndrome and GEP-NET patients has also been found [69].…”

Pancreatic neuroendocrine neoplasms: survival trend analysis of a comprehensive center

“…Regarding secondary malignancies, a retrospective study of USA SEER database on GEP-NEN found an occurrence of second cancers in 25.8%, though this risk was only associated with gastro-intestinal NEN ( Kauffmann et al 2014 ). One study reported an association between metabolic syndrome and well-differentiated GEP-NEN, and others reported diabetes mellitus as a possible risk factor for the development of Pan-NEN ( Haugvik et al 2015 , Leoncini et al 2016 , Santos et al 2018 , Zhuge et al 2020 ). Concerning functioning tumors known to be associated with hyperglycemia, we only have five cases – three glucagonoma and two ACTHoma-related Cushing’s syndrome.…”