Pancreatic cancer-associated diabetes mellitus is characterized by reduced ß-cell secretory capacity, rather than insulin resistance.

AIMS: The early distinction of pancreatic cancer associated diabetes (PaCDM) in patients with elderly diabetes is critical. However, PaCDM and type 2 diabetes mellitus (T2DM) remain indistinguishable. We aim to address the differences between the pancreatic and gut endocrine hormones of patients with PaCDM and T2DM. METHODS: A total of 44 participants underwent mixed meal tolerance test (MMTT). Fasting and postprandial concentrations of insulin, C-peptide, glucagon, pancreatic polypeptide (PP), glucagon-like peptide-1 (GLP-1), and gastric inhibitory peptide (GIP) were measured. Insulin sensitivity and secretion indices were calculated. One-way ANOVA with post-hoc analysis was used for statistical analysis. RESULTS: Insulin and C-peptide responses to MMTT were blunted in PaCDM patients compared with T2DM. Baseline concentrations and AUCs differed. PaCDM patients showed lower insulin secretion capacity but better insulin sensitivity than T2DM patients. The peak concentration and AUC of PP in T2DM group were higher than healthy controls, but in accordance with PaCDM. PaCDM patients presented lower baseline GLP-1 concentration than T2DM patients. No between-group differences were found for glucagon and GIP. CONCLUSIONS: PaCDM patients had a lower baseline and postprandial insulin and C-peptide secretion than T2DM patients. Reduced insulin secretion and improved peripheral sensitivity were found in PaCDM patients compared with T2DM.

Serum REG Iα as a potential novel biomarker in cancer: An observational study.

The regulation of the gene-regenerating family member 1 alpha (REG Iα) played important roles in cancer cell biology. However, the correlation between its gene product serum REG Iα and cancer has not been evaluated. In this observational study, 130 hospitalized patients from the department of internal medicine in Zhongda Hospital Southeast University were included and assigned to cancer or noncancer groups. History, clinical, and laboratory data were obtained. Serum REG Iα levels and alanine aminotransferase were found significantly higher in patients with cancer (P < .001 and P < .05 respectively). Logistic regression analysis indicated that REG Iα was an independent risk factor for cancer (P < .001). The area under the curve of REG Iα was 0.764 and the optimal cut-off point of REG Iα was 46.97 ng/mL. Besides, the cancer patients with metastasis had significantly higher serum REG Iα levels than those in nonmetastasis cancer group (P < .05). In conclusion, serum REG Iα was significantly elevated in patients with cancer, and it might be a potential biomarker in predicting cancer occurrence and development.

Association between lipoprotein-associated phospholipase A2 and lower extremity arterial disease in type 2 diabetes mellitus.

BACKGROUND: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is closely related to the development of cardiovascular diseases, and the association between Lp-PLA2 and lower extremity arterial disease (LEAD) in type 2 diabetes mellitus (T2DM) is inconsistent among previous studies. Thus, the present study aimed to investigate whether the increase in Lp-PLA2 is related to the occurrence of LEAD in patients with T2DM. METHODS: A total of 519 patients with T2DM (173 patients with LEAD and 346 patients without LEAD) were enrolled in this study. The demographics, medical history, serum lipids, glycosylated hemoglobin, Lp-PLA2, and ankle-brachial index (ABI) were recorded and analyzed. RESULTS: The diabetes duration, prevalence of female, prevalence of hypertension, and Lp-PLA2 concentration in the LEAD group were significantly higher than those in the non-LEAD group (duration of diabetes: 15 [10-20] vs 8 [2-12] years, prevalence of female: 49.13% vs 38.73%, prevalence of hypertension: 58.38% vs 38.11%, Lp-PLA2: 145 [108-178] vs 125 [107-138] ng/ml, p < 0.05). Lp-PLA2 was negatively correlated with ABI (r = -0.308, p < 0.001). Results of multivariate logistic regression analysis showed that serum Lp-PLA2 was an independent factor for the development of LEAD (odds ratio: 1.018 [1.007-1.029], P = 0.001). CONCLUSIONS: Increased serum Lp-PLA2 concentrations are associated with LEAD in patients with T2DM. They are an independent risk factor for the occurrence of LEAD.