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Abstract：
BACKGROUND: To elucidate the relationship between the triglyceride-glycemic index (TyG) and clinical characteristics of pancreatic ductal adenocarcinoma (PDAC).
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.
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.
摘要：
背景：阐明甘油三酸酯-血糖指数（TyG）与胰腺导管腺癌（PDAC）临床特征之间的关系。
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。
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。
