METHODS: A total of 1,594 individuals diagnosed with pancreatic and periampullary neoplasms were categorized into four groups: PDAC-early (n = 403), locally advanced PDAC (LAPC, n = 315), PDAC-late with distant metastasis (n = 371), and other tumor types (n = 505). TyG-high was defined as a TyG index greater than 8.81 in males and 8.73 in females.
RESULTS: The prevalence of TyG-high status was highest in PDAC-early (68.48%), followed by LAPC (53.33%), and lowest in PDAC-late (44.47%). TyG-high status significantly predicted worse PDAC prognosis (P = 0.0166), particularly in PDAC-late (P = 0.0420). Despite similar blood glucose levels across PDAC groups (P = 0.897), PDAC-early patients showed significantly higher rates of glycemic disturbances (56.33% vs. 32.28%) and TyG-high status (68.48% vs. 47.13%) compared to those with other tumors. Progressive increases in glycemic disturbances and TyG-high status were observed from benign to pre-malignant lesions and PDAC-early. PDAC-early patients at the pancreatic head exhibited higher rates of glycemic disturbances (58.12% vs. 33.33%, P < 0.0001), larger pancreatic duct diameters (0.4056 cm vs. 0.3398 cm, P = 0.0043), and poorer prognosis compared to periampullary cancers, although the TyG-high rate and body mass index were similar.
CONCLUSIONS: The TyG index exhibits a complex association with PDAC stages, profoundly shaping glycemic profiles. At the initial stages of PDAC, a notable elevation in TyG-high status and glycemic disturbances is observed. However, in advanced PDAC, while the TyG-high rate diminishes, abnormal glucose levels persist.
方法:共有1,594名诊断为胰腺和壶腹周围肿瘤的个体被分为四组:PDAC早期(n=403),本地先进的PDAC(LAPC,n=315),PDAC-晚期远处转移(n=371),和其他肿瘤类型(n=505)。TyG-high被定义为男性的TyG指数大于8.81,女性的TyG指数大于8.73。
结果:在PDAC早期,TyG高状态的患病率最高(68.48%),其次是LAPC(53.33%),PDAC晚期最低(44.47%)。TyG高状态显着预测PDAC预后较差(P=0.0166),特别是在PDAC晚期(P=0.0420)。尽管PDAC组的血糖水平相似(P=0.897),PDAC早期患者的血糖紊乱发生率明显较高(56.33%vs.32.28%)和TyG高状态(68.48%与47.13%)与其他肿瘤相比。从良性到恶性前病变和PDAC早期,观察到血糖紊乱和TyG高状态的逐渐增加。PDAC-早期患者在胰头表现出更高的血糖紊乱率(58.12%vs.33.33%,P<0.0001),较大的胰管直径(0.4056cm与0.3398厘米,P=0.0043),与壶腹周围癌相比,预后较差,尽管TyG高率和体重指数相似。
结论:TyG指数表现出与PDAC阶段的复杂关联,深刻塑造血糖状况。在PDAC的初始阶段,观察到TyG高状态和血糖紊乱显著升高.然而,在先进的PDAC中,而TyG高利率下降,葡萄糖水平异常持续存在。