急性胰腺炎后并发糖尿病的研究进展
Research Progress of Diabetes Mellitus after Acute Pancreatitis
DOI: 10.12677/ACM.2023.1371515, PDF,   
作者: 夏 晶:青海大学研究生院,青海 西宁;吴海涛:青海大学附属医院急诊内科,青海 西宁
关键词: 急性胰腺炎糖尿病急性胰腺炎后糖尿病非酒精性脂肪肝发病机制Acute Pancreatitis Diabetes Diabetes after Acute Pancreatitis NAFLD Pathogenesis
摘要: 随着我国经济发展水平的提高人们的生活、作息、饮食水平的改变,急性胰腺炎是患者向急诊科就诊的常见原因,胰腺是与消化道相连的最大腺体之一,也是兼有内、外分泌功能的器官。其所分泌的胰岛素是人体内惟一有降低血糖作用的激素。急性胰腺炎后糖尿病的发病率仅次于二型糖尿病成为第二大常见原因,其发病年龄较年轻、易复发、预后差等临床特点,急性胰腺炎后糖尿病越来越被人们重视。本文对急性胰腺炎后糖尿病的病因、临床特点、发病机制、诊断方面及影响因素予以综述。
Abstract: With the improvement of China’s economic development level and changes in people’s living, rest, and diet, acute pancreatitis is a common cause for patients to seek medical attention from the emergency department. The pancreas is one of the largest glands connected to the digestive tract and is also an organ with both endocrine and exocrine functions. The insulin secreted by it is the only hormone in the human body that has the effect of lowering blood sugar. The incidence rate of diabetes after acute pancreatitis is only second to type 2 diabetes as the second most common cause. Its clinical characteristics such as younger onset age, easy recurrence, poor prognosis, etc., and dia-betes after acute pancreatitis are increasingly valued. This article reviews the etiology, clinical characteristics, pathogenesis, diagnosis and influencing factors of diabetes after acute pancreatitis.
文章引用:夏晶, 吴海涛. 急性胰腺炎后并发糖尿病的研究进展[J]. 临床医学进展, 2023, 13(7): 10848-10853. https://doi.org/10.12677/ACM.2023.1371515

参考文献

[1] Keller, J. and Layer, P. (2005) Human Pancreatic Exocrine Response to Nutrients in Health and Disease. Gut, 54, 1-28. [Google Scholar] [CrossRef] [PubMed]
[2] Firkins, S.A., Hart, P.A., Papachristou, G.I., Lara, L.F., Cruz-Monserrate, Z., Hinton, A., Conwell, D.L., Bradley, D.P. and Krishna, S.G. (2021) Identification of a Risk Profile for New-Onset Diabetes after Acute Pancreatitis. Pancreas, 50, 696-703. [Google Scholar] [CrossRef
[3] Covino, M., Quero, G., Ojetti, V., Cina, C., Galiandro, F., Longo, F., Torelli, E., Fiorillo, C., Menghi, R., Simeoni, B., Franceschi, F. and Alfieri, S. (2020) Atypical Presentation of Acute Pancreatitis: A Single Center Case-Match Analysis of Clinical Outcomes. European Review for Medical and Pharmacological Sciences, 24, 813-820.
[4] Rinninella, E., Annetta, M.G., Serricchio, M.L., Dal Lago, A.A., Mig-giano, G.A. and Mele, M.C. (2017) Nutritional Support in Acute Pancreatitis: From Physiopathology to Practice. An Evidence-Based Approach. European Review for Medical and Pharmacological Sciences, 21, 421-432.
[5] Pagliari, D., Brizi, M.G., Saviano, A., Mancarella, F.A., Dal Lago, A.A., Serricchio, M.L., Newton, E.E., Attili, F., Manfredi, R. and Gasbarrini, A. (2019) Clinical Assessment and Management of Severe Acute Pancreatitis: A Multi-Disciplinary Ap-proach in the XXI Century. European Review for Medical and Pharmacological Sciences, 23, 771-787.
[6] Forsmark, C.E., Vege, S.S. and Wilcox, C.M. (2016) Acute Pancreatitis. The New England Journal of Medicine, 375, 1972-1981. [Google Scholar] [CrossRef
[7] Hart, P.A., Bradley, D., Conwell, D.L., Dungan, K., Krishna, S.G., Wyne, K., Bellin, M.D., Yadav, D., Andersen, D.K., Serrano, J. and Papachristou, G.I. (2021) Diabetes following Acute Pancreatitis. The Lancet Gastroenterology and Hepatology, 6, 668-675. [Google Scholar] [CrossRef
[8] Richardson, A. and Park, W.G. (2021) Acute Pancreatitis and Diabetes Mellitus: A Review. The Korean Journal of Internal Medicine, 36, 15-24. [Google Scholar] [CrossRef] [PubMed]
[9] Petrov, M.S. and Yadav, D. (2019) Global Epidemiology and Holistic Prevention of Pancreatitis. Nature Reviews Gastroenterology & Hepatology, 16, 175-184. [Google Scholar] [CrossRef] [PubMed]
[10] Das, S.L., Singh, P.P., Phillips, A.R., Murphy, R., Windsor, J.A. and Petrov, M.S. (2014) Newly Diagnosed Diabetes Mellitus after Acute Pancreatitis: A Systematic Review and Me-ta-Analysis. Gut, 63, 818-831. [Google Scholar] [CrossRef] [PubMed]
[11] Pendharkar, S.A., Mathew, J., Zhao, J., Windsor, J.A., Exeter, D.J. and Petrov, M.S. (2017) Ethnic and Geographic Variations in the Incidence of Pancreatitis and Post-Pancreatitis Di-abetes Mellitus in New Zealand: A Nationwide Population-Based Study. The New Zealand Medical Journal, 130, 55-68.
[12] Woodmansey, C., McGovern, A.P., McCullough, K.A., Whyte, M.B., Munro, N.M., Correa, A.C., et al. (2017) Incidence, Demographics, and Clinical Characteristics of Diabetes of the Exocrine Pancreas (Type 3c): A Retro-spective Cohort Study. Diabetes Care, 40, 1486-1493. [Google Scholar] [CrossRef] [PubMed]
[13] Pendharkar, S.A., Mathew, J. and Petrov, M.S. (2017) Age- and Sex-Specific Prevalence of Diabetes Associated with Diseases of the Ex-ocrine Pancreas: A Population-Based Study. Digestive and Liver Disease, 49, 540-544. [Google Scholar] [CrossRef] [PubMed]
[14] Cho, J., Scragg, R. and Petrov, M.S. (2019) Risk of Mortality and Hospitalization after Post-Pancreatitis Diabetes Mellitus vs Type 2 Diabetes Mellitus: A Population-Based Matched Co-hort Study. The American Journal of Gastroenterology, 114, 804-812. [Google Scholar] [CrossRef] [PubMed]
[15] Cho, J., Scragg, R., Pandol, S.J., Goodarzi, M.O. and Petrov, M.S. (2019) Antidiabetic Medications and Mortality Risk in Individuals with Pancreatic Cancer-Related Diabetes and Postpancreatitis Diabetes: A Nationwide Cohort Study. Diabetes Care, 42, 1675-1683. [Google Scholar] [CrossRef] [PubMed]
[16] Das, S.L., Singh, P.P., Phillips, A.R., Murphy, R., Windsor, J.A. and Pe-trov, M.S. (2014) Newly Diagnosed Diabetes Mellitus after Acute Pancreatitis: A Systematic Review and Meta-Analysis. Gut, 63, 818-831. [Google Scholar] [CrossRef] [PubMed]
[17] Czako, L., Hegyi, P., Rakonczay Jr, Z., Wittmann, T. and Otsuki, M. (2009) Interactions between the Endocrine and Exocrine Pancreas and Their Clinical Relevance. Pancreatology, 9, 351-359. [Google Scholar] [CrossRef] [PubMed]
[18] Gornik, I., Vujaklija, A., Lukic, E., Madžarac, G. and Gašparović, V. (2010) Hyperglycemia in Sepsis Is a Risk Factor for Development of Type II Diabetes. Journal of Critical Care, 25, 263-269. [Google Scholar] [CrossRef] [PubMed]
[19] Malecka-Panas, E., Gasiorowska, A., Kropiwnicka, A., Zlobinska, A. and Drzewoski, J. (2002) Endocrine Pancreatic Function in Patients after Acute Pancreatitis. Hepatogas-troenterology, 49, 1707-1712.
[20] Schepers, N.J., Bakker, O.J., Besselink, M.G., et al. (2019) Impact of Characteris-tics of Organ Failure and Infected Necrosis on Mortality in Necrotising Pancreatitis. Gut, 68, 1044-1051. [Google Scholar] [CrossRef] [PubMed]
[21] Wynne, K., Devereaux, B. and Dornhorst, A. (2019) Diabetes of the Exocrine Pancreas. Journal of Gastroenterology and Hepatology, 34, 346-354. [Google Scholar] [CrossRef] [PubMed]
[22] Andersen, D.K., Andren-Sandberg, Å., Duell, E.J., Goggins, M., Korc, M., Petersen, G.M., Smith, J.P. and Whitcomb, D.C. (2013) Pancreatitis-Diabetes-Pancreatic Cancer: Summary of an NIDDK-NCI Workshop. Pancreas, 42, 1227-1237. [Google Scholar] [CrossRef
[23] Frier, B.M., Saunders, J.H., Wormsley, K.G. and Bouchier, I.A. (1976) Exocrine Pancreatic Function in Juvenile-Onset Diabetes Mellitus. Gut, 17, 685-691. [Google Scholar] [CrossRef] [PubMed]
[24] Ewald, N., Raspe, A., Kaufmann, C., Bretzel, R.G., Kloer, H.U. and Hardt, P.D. (2009) Determinants of Exocrine Pancreatic Function as Measured by Fecal Elastase-1 Concentrations (FEC) in Patients with Diabetes Mellitus. European Journal of Medical Research, 14, Article No. 118. [Google Scholar] [CrossRef
[25] Kawabe, K., Ito, T., Igarashi, H. and Takayanagi, R. (2009) The Current Managements of Pancreatic Diabetes in Japan. Clinical Journal of Gastroenterology, 2, 1-8. [Google Scholar] [CrossRef] [PubMed]
[26] Ewald, N. and Hardt, P.D. (2013) Diagnosis and Treatment of Diabetes Mellitus in Chronic Pancreatitis. World Journal of Gastroenterology, 19, 7276-7281. [Google Scholar] [CrossRef] [PubMed]
[27] Monnier, L., Mas, E., Ginet, C., Michel, F., Villon, L., Cristol, J.P., et al. (2006) Activation of Oxidative Stress by Acute Glucose Fluctuations Compared with Sustained Chronic Hypergly-cemia in Patients with Type 2 Diabetes. JAMA, 295, 1681-1687. [Google Scholar] [CrossRef] [PubMed]
[28] 陈晨. 糖尿病合并急性胰腺炎与非糖尿病急性胰腺炎的CT/MRI表现与临床特点对比研究[D]: [硕士学位论文].南充: 川北医学院, 2017.
[29] 位影. 非酒精性脂肪肝对急性胰腺炎病程的影响[D]: [硕士学位论文]. 长春: 吉林大学, 2020.[CrossRef
[30] Petrov, M.S. and Basina, M. (2021) Diagnosis of Endo-crine Disease: Diagnosing and Classifying Diabetes in Diseases of the Exocrine Pancreas. European Journal of Endo-crinology, 184, R151-R163. [Google Scholar] [CrossRef
[31] Frossard, J.L., Lescuyer, P. and Pastor, C.M. (2009) Experimental Evidence of Obesity as a Risk Factor for Severe Acute Pancreatitis. World Journal of Gas-troenterology, 15, 5260-5265. [Google Scholar] [CrossRef] [PubMed]
[32] Lv, Y., Zhang, J., Yang, T., Sun, J., Hou, J., Chen, Z., Yu, X., Yuan, X., Lu, X., Xie, T., Yu, T., Su, X., Liu, G., Zhang, C. and Li, L. (2022) Non-Alcoholic Fatty Liver Disease (NAFLD) Is an Independent Risk Factor for Developing New-Onset Diabetes after Acute Pancreatitis: A Multicenter Retrospective Cohort Study in Chinese Population. Frontiers in Endocrinology, 13, Article 903731. [Google Scholar] [CrossRef] [PubMed]
[33] Pinkney, J.H., Stehouwer, C.D., Coppack, S.W. and Yudkin, J.S. (1997) Endothelial Dysfunction: Cause of the Insulin Resistance Syndrome. Diabetes, 46, S9-S13. [Google Scholar] [CrossRef
[34] 刘杰, 沈玄霖, 刘遂心. 非糖尿病代谢综合征患者胰岛素抵抗相关因素分析[J]. 中国医师杂志, 2006, 8(5): 672-673.
[35] Fraenkel, E., Takács, R., Hamvas, J., Lengyel, G. and Fehér, J. (2007) Common Occurrence of Nonalcoholic Fatty Liver Disease and Cholecystolithiasis. Orvosi Hetilap, 148, 793-798. [Google Scholar] [CrossRef] [PubMed]