胰岛素瘤与非功能性胰腺神经内分泌肿瘤临床特征及血脂代谢差异分析

Analysis of Differences in Clinical Characteristics and Lipid Profiles between Insulinoma and Nonfunctional Pancreatic Neuroendocrine Neoplasms

摘要: 目的：探讨胰岛素瘤与非功能性胰腺神经内分泌肿瘤(pancreatic neuroendocrine neoplasms, PNEN)患者临床特征及血脂指标的差异，并分析相关影响因素。方法：回顾性收集2017年1月至2024年12月在我院诊治的PNEN患者148例，其中胰岛素瘤39例，非功能性PNEN 109例。收集患者一般临床资料、肿瘤病理特征及血脂相关指标，包括总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(Non-HDL-C)、载脂蛋白A1 (ApoA1)、载脂蛋白B (ApoB)、脂蛋白a [Lp(a)]及游离脂肪酸(FFA)等。比较两组患者临床特征及血脂指标差异，并采用多因素Logistic回归分析胰岛素瘤的相关因素。结果：与非功能性PNEN相比，胰岛素瘤患者BMI水平较高，肿瘤体积较小，TC、LDL-C、Non-HDL-C及FFA水平均较低，差异具有统计学意义(P < 0.05)。多因素Logistic回归分析结果显示，性别、肿瘤大小、BMI、Non-HDL-C及FFA均与胰岛素瘤相关(P < 0.05)。结论：与非功能性PNEN相比，胰岛素瘤患者在临床特征及血脂指标方面存在一定差异，提示胰岛素瘤患者可能存在特征性的脂代谢改变。

Abstract: Objective: To investigate the differences in clinical characteristics and lipid profiles between insulinoma and nonfunctional pancreatic neuroendocrine neoplasms (PNENs), and to analyze the associated factors. Methods: A total of 148 patients with PNENs who were diagnosed and treated in our hospital between January 2017 and December 2024 were retrospectively analyzed, including 39 patients with insulinoma and 109 patients with nonfunctional PNENs. Clinical data, tumor pathological characteristics, and serum lipid parameters were collected, including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (Non-HDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), lipoprotein(a) [Lp(a)], and free fatty acid (FFA). Differences in clinical characteristics and lipid profiles between the two groups were compared. Multivariate logistic regression analysis was performed to identify factors associated with insulinoma. Results: Compared with patients with nonfunctional PNENs, patients with insulinoma had higher body mass index (BMI) and smaller tumor size, while TC, LDL-C, Non-HDL-C, and FFA levels were significantly lower (P < 0.05). Multivariate logistic regression analysis showed that sex, tumor size, BMI, Non-HDL-C, and FFA were significantly associated with insulinoma (P < 0.05). Conclusion: Patients with insulinoma exhibit distinct clinical characteristics and lipid profiles compared with those with nonfunctional PNENs, suggesting that insulinoma may be associated with characteristic alterations in lipid metabolism.