INTRODUCTION: Diabetes (T3cDM) secondary to chronic pancreatitis (CP) arises due to endocrine dysfunction and metabolic dysregulations. Currently, diagnostic tests are not available to identify ...patients who may progress from normoglycemia to hyperglycemia in CP. We conducted plasma metabolomic profiling to diagnose glycemic alterations early in the course of disease. METHODS: Liquid chromatography-tandem mass spectrometry was used to generate untargeted, targeted plasma metabolomic profiles in patients with CP, controls (n = 445) following TRIPOD guidelines. Patients were stratified based on glucose tolerance tests following ADA guidelines. Multivariate analysis was performed using partial least squares discriminant analysis to assess discriminatory ability of metabolites among stratified groups. COMBIROC and logistic regression were used to derive biomarker signatures. AI-ML tool (Rapidminer) was used to verify these preliminary results. RESULTS: Ceramide, lysophosphatidylethanolamine, phosphatidylcholine, lysophosphatidic acid (LPA), phosphatidylethanolamine, carnitine, and lysophosphatidylcholine discriminated T3cDM CP patients from healthy controls with AUC 93% (95% CI 0.81–0.98, P < 0.0001), and integration with pancreatic morphology improved AUC to 100% (95% CI 0.93–1.00, P < 0.0001). LPA, phosphatidylinositol, and ceramide discriminated nondiabetic CP with glycemic alterations (pre-diabetic CP); AUC 66% (95% CI 0.55–0.76, P = 0.1), and integration enhanced AUC to 74% (95% CI 0.55–0.88, P = 0.86). T3cDM was distinguished from prediabetic by LPA, phosphatidylinositol, and sphinganine (AUC 70%; 95% CI 0.54–0.83, P = 0.08), and integration improved AUC to 83% (95% CI 0.68–0.93, P = 0.05). CombiROC cutoff identified 75% and 78% prediabetes in validation 1 and 2 cohorts. Random forest algorithm assessed performance of integrated panel demonstrating AUC of 72% in predicting glycemic alterations. DISCUSSION: We report for the first time that a panel of metabolites integrated with pancreatic morphology detects glycemia progression before HbA1c in patients with CP.
New approach for the investigation of pancreatic duct in mice Gál, E.; Dolensek, J.; Stozer, A. ...
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... et al.,
November 2020, 2020-11-00, 20201101, Letnik:
20
Journal Article
Standardisation of the concept of soft and hard pancreas Kanikovskiy, O.; Pavlyk, I.; Oliinyk, I. ...
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... et al.,
November 2020, 2020-11-00, 20201101, Letnik:
20
Journal Article
OPTN/SRTR 2018 Annual Data Report: Pancreas Kandaswamy, R.; Stock, P. G.; Gustafson, S. K. ...
American journal of transplantation,
January 2020, 2020-01-00, 20200101, Letnik:
20, Številka:
s1
Journal Article
Recenzirano
Odprti dostop
The overall number of pancreas transplants continued to increase to 1027 in 2018, after a nadir of 947 in 2015. New additions to waiting list remained stable, with 1485 candidates added in 2018. ...Proportions of patients with type II diabetes waiting for transplant (14.6%) and undergoing transplant (14.8%) have steadily increased since 2016. Waiting times for simultaneous pancreas/kidney transplant have decreased; median months to transplant was 13.5 for simultaneous pancreas/kidney transplant and 19.7 for pancreas transplant alone in 2018. Outcomes, including patient and kidney survival, as well as rejection rates, have improved consistently over the past several years. Pancreas graft survival data are being collected by the Organ Procurement and Transplantation Network and will be included in a future report once there are sufficient cohorts for analysis.
OPTN/SRTR 2017 Annual Data Report: Pancreas Kandaswamy, R.; Stock, P. G.; Gustafson, S. K. ...
American journal of transplantation,
February 2019, 2019-02-00, 20190201, Letnik:
19, Številka:
S2
Journal Article
Recenzirano
Odprti dostop
In 2017, 1492 patients were added to the pancreas transplant waiting list, 964 listed as active, a slight increase from 2016. This is significant because for the first time in the past decade, the ...steady downward trend in additions to the waiting list has been reversed. Proportions of pancreas donors with cerebrovascular accident as cause of death decreased, with a concomitant increase in proportions with anoxia and head trauma. This is partly a result of the national opioid crisis, and it reflects increasing use of younger donors for pancreas transplant. The 2017 outcome report remains compromised by previous variation in reporting graft failure. Although the OPTN Pancreas Transplantation Committee has approved more precise definitions of pancreas graft failure, implementation of these definitions took place recently, and the data are not reflected in this report.
Foetal pancreatic tissue as a model for human pancreatic ducts Für, Gabriella; Kiss, Lóránd; Balla, Zsolt ...
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... et al.,
June 2019, 2019-06-00, 20190601, Letnik:
19
Journal Article
This is a protocol for a Cochrane Review (intervention). The objectives are as follows:
To compare the efficacy and safety of neoadjuvant chemotherapy or chemoradiotherapy versus upfront surgery ...alone in patients with resectable or borderline resectable pancreatic cancer.
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