Distinguishing exocrine pancreas disease-associated diabetes from type 2 diabetes based on anthropometric and metabolic parameters

doi:10.4239/wjd.v16.i2.95102

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Diabetes. Feb 15, 2025; 16(2): 95102
Published online Feb 15, 2025. doi: 10.4239/wjd.v16.i2.95102

Table 1 Demographic and anthropometric characteristics of the study groups

Parameter	PC + CP, n = 44	T2DM, n = 35	P value
Sex
Female	16 (36.4)	21 (60.0)	0.062
Male	28 (63.6)	14 (40.0)	0.062
Age in years	60.0 ± 9.7	60.7 ± 6.9	0.828
BMI (kg/m²)	25.11 ± 4.87	30.83 ± 5.21	< 0.001^a
Obesity, ≥ 30	5 (11.4)	17 (48.6)	< 0.001^a
Overweight, 25-29.9	16 (36.4)	15 (42.9)
Normal + underweight, < 25	23 (52.3)	3 (8.6)

^aP < 0.001.

Results are presented as mean ± SD or n (%). CP: Chronic pancreatitis; PC: Pancreatic cancer; T2DM: Type 2 diabetes mellitus.

Table 2 Laboratory and metabolic parameters of the study groups

Parameter	PC + CP, n = 44		T2DM, n = 35		P value
Parameter	mean ± SD	Median (IQR)	mean ± SD	Median (IQR)	P value
Fasting plasma glucose (mmol/L)	7.22 ± 2.87	6.22 (5.36-8.00)	7.13 ± 1.99	6.50 (5.94-7.50)	0.341
Insulin (pmol/L)	76.81 ± 63.34	58.54 (37.78-98.06)	233.19 ± 164.51	185.76 (95.07-347.57)	< 0.001^a
C-peptide (nmol/L)	0.81 ± 0.42	0.77 (0.47-1.07)	1.71 ± 0.80	1.69 (1.46-2.04)	< 0.001^a
HOMA-IR	3.70 ± 3.25	2.67 (1.44-5.10)	11.21 ± 9.82	8.24 (3.73-15.14)	< 0.001^a
Adrenomedullin (ng/mL)	0.41 ± 0.25	0.35 (0.23-0.50)	0.63 ± 0.38	0.51 (0.32-0.86)	0.004^b
Adiponectin (μg/mL)	13.08 ± 7.20	11.58 (7.96-17.53)	8.28 ± 4.01	6.73 (5.71-10.01)	< 0.001^a
Type 3c diabetes index	1.93 ± 0.63	1.87 (1.62-2.31)	3.04 ± 0.71	3.03 (2.50-3.55)	< 0.001^a
Creatinine (μmol/L)	63.7 ± 41.6	55.7 (48.6-63.7)	75.1 ± 23.9	66.3 (59.2-76.0)	< 0.001^a^,^c
eGFR (mL/min/1.73 m²)	100.53 ± 21.60	100.10 (95.25-110.23)	85.14 ± 19.24	91.00 (74.60-98.00)	< 0.001^a

^aP < 0.001.

^bP < 0.01.

^cStatistical power < 0.800.

IQR: Interquartile range; CP: Chronic pancreatitis; PC: Pancreatic cancer; T2DM: Type 2 diabetes mellitus; HOMA-IR: Homeostasis model assessment of insulin resistance; eGFR: Epidermal growth factor receptor.

Table 3 Cut-off points and odds ratios for independent markers of pancreatogenic diabetes in the study groups

Parameter	Probability of pancreatogenic diabetes
Parameter	Cut-off point	Sensitivity (%)	Specificity (%)	OR (95%CI)	P value
Type 3c diabetes index	< 2.40	84.1	80.0	21.14 (6.65-67.24)	< 0.001^a
Insulin (pmol/L)	< 85.00	75.0	82.9	14.50 (4.77-44.12)	< 0.001^a
BMI (kg/m²)	< 24.6	50.0	97.1	16.50 (3.52-77.34)	< 0.001^a
eGFR (mL/min/1.73 m²)	> 96.0	75.0	71.4	7.50 (2.75-20.42)	< 0.001^a
Adrenomedullin (ng/mL)	< 0.49	72.7	60.0	4.00 (1.55-10.32)	0.007^b

^aP < 0.001.

^bP < 0.01.

95%CI: 95% confidence interval; OR: Odds ratio; BMI: Body mass index; eGFR: Epidermal growth factor receptor.

Table 4 Demographic and anthropometric characteristics of patients with pancreatogenic diabetes

Parameter	PC, n = 26	CP, n = 18	P value
Sex
Female	14	2	0.010^a^,^b
Male	12	16	0.010^a^,^b
Age (years)	65.5 ± 4.7	52.1 ± 9.8	< 0.001^c
BMI (kg/m²)	25.87 ± 5.43	24.00 ± 3.81	0.214
Obesity, ≥ 30	5	0	0.137
Overweight, 25-29.9	9	7
Normal + underweight, < 25	12	11

^aP < 0.05.

^bStatistical power < 0.800.

^cP < 0.001.

Results are presented as mean ± SD or n. CP: Chronic pancreatitis; PC: Pancreatic cancer; BMI: Body mass index

Table 5 Laboratory and metabolic parameters of patients with pancreatogenic diabetes

Parameter	Pancreatic cancer, n = 26		Chronic pancreatitis, n = 18		P value
Parameter	mean ± SD	Median (IQR)	mean ± SD	Median (IQR)	P value
Fasting plasma glucose (mmol/L)	6.61 ± 2.23	5.97 (5.38-7.17)	8.11 ± 3.48	6.83 (5.31-9.39)	0.104
C-peptide (nmol/L)	0.86 ± 0.42	0.79 (0.56-1.12)	0.75 ± 0.41	0.76 (0.36-0.92)	0.407
Insulin (pmol/L)	60.49 ± 6.73	46.74 (35.98-69.03)	100.29 ± 77.09	61.74 (45.77-152.72)	0.061
HOMA-IR	2.79 ± 2.39	2.36 (1.27-3.12)	5.00 ± 3.92	3.24 (2.27-7.10)	0.026^a^,^b
Adrenomedullin (ng/mL)	0.33 ± 0.18	0.27 (0.20-0.47)	0.54 ± 0.28	0.45 (0.35-0.65)	0.004^c
Adiponectin (μg/mL)	14.27 ± 8.06	11.89 (8.46-20.50)	11.14 ± 5.17	10.50 (6.98-13.34)	0.294
Type 3c diabetes index	1.76 ± 0.59	1.77 (1.41-2.13)	2.18 ± 0.61	2.01 (1.77-2.75)	0.028^a^,^b
Creatinine (µmol/L)	60.11 ± 14.14	55.69 (52.16-64.53)	68.95 ± 63.65	57.46 (44.20-62.76)	0.390
eGFR (mL/min/1.73 m²)	94.18 ± 13.94	98.15 (91.85-101.38)	109.71 ± 27.27	111.30 (100.50-128.00)	< 0.001^b^,^d

^aP < 0.05.

^bStatistical power < 0.800.

^cP < 0.01.

^dP < 0.001.

IQR: Interquartile range; HOMA-IR: Homeostatic model assessment for insulin resistance; eGFR: Epidermal growth factor receptor.

Citation: Juza A, Kołodziej-Spirodek L, Gutkowski K, Partyka M, Dąbrowski M. Distinguishing exocrine pancreas disease-associated diabetes from type 2 diabetes based on anthropometric and metabolic parameters. World J Diabetes 2025; 16(2): 95102
URL: https://www.wjgnet.com/1948-9358/full/v16/i2/95102.htm
DOI: https://dx.doi.org/10.4239/wjd.v16.i2.95102