Prevalence of Pancreatic Cancer in Diabetics and Clinical Characteristics of Diabetes-associated with Pancreatic Cancer - Comparison between Diabetes with and without Pancreatic Cancer -

Seung Goun Hong; Jae Seon Kim; Sung Joo Jung; Moon Kyung Joo; Beom Jae Lee; Jong Eun Yeon; Jong-Jae Park; Kwan Soo Byun; Young-Tae Bak

doi:10.4166/kjg.2009.54.3.167

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Hong, Kim, Jung, Joo, Lee, Yeon, Park, Byun, and Bak: Prevalence of Pancreatic Cancer in Diabetics and Clinical Characteristics of Diabetes-associated with Pancreatic Cancer - Comparison between Diabetes with and without Pancreatic Cancer -

Original Article

Korean J Gastroenterol 2009;54(3):167-173.

Published online: 21 February 2009

DOI: https://doi.org/10.4166/kjg.2009.54.3.167

Prevalence of Pancreatic Cancer in Diabetics and Clinical Characteristics of Diabetes-associated with Pancreatic Cancer - Comparison between Diabetes with and without Pancreatic Cancer -

Seung Goun Hong, M.D., Jae Seon Kim, M.D., Sung Joo Jung, M.D., Moon Kyung Joo, M.D., Beom Jae Lee, M.D., Jong Eun Yeon, M.D., Jong-Jae Park, M.D., Kwan Soo Byun, M.D., Young-Tae Bak, M.D.

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

Correspondence to: Jae Seon Kim, M.D. Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, 97, Gurodong-gil, Guro-gu, Seoul 152-703, Korea Tel: +82-2-2626-3002, Fax: +82-2-837-1966 E-mail: kimjs@kumc.or.kr

Received 23 December 2008 Accepted 30 March 2009

Abstract

Background/Aims

In Korea, the prevalence of pancreatic cancer (PC) in general population has been reported as 7 in 100,000. However, that in diabetes mellitus (DM) has not been elucidated yet. This study was designed to estimate the prevalence of PC among DM patients, and characterize and compare the patients with DM with and without PC.

Methods

5,082 patients (4,890 DM without PC, 78 PC with DM, and 114 PC without DM) were enrolled from Korea University Guro Hospital during a period of 4 years between January 2004 and January 2008.

Results

The prevalence of PC in DM patients was 1.6% and that of DM in PC patients was 40.6%. No significant differences in the clinical characteristics except HbAIc and ALP were observed between PC patients with DM and without DM. Among 78 PC patients with DM, DM was diagnosed in 19 (29.4%) and 29 (37.1%) patients concomitantly or within 2 years prior to the diagnosis of PC, respectively. Among the cases with recent onset DM (less than 2 years’ duration), the disease duration of DM before the diagnosis of PC was less than 1 year in 14 patients (17.9%) and 1 to 2 years in 15 patients (19.2%). DM patients with PC were found to have significantly higher ALT, total bilirubin, and ALP levels than in DM patients without PC.

Conclusions

The prevalence of PC in DM patients was 1.6% and was higher than in the general population. Recent onset DM was frequent in PC patients (less than 2 years' duration). We recommend close follow-up for at least 2 years in new-onset diabetes.

Keywords: Pancreatic cancer, Diabetes mellitus, Prevalence, Disease duration

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Table 1.

The Comparison of Clinical Characteristics between Pancreatic Cancer Patients with and without Diabetes Mellitus

Characteristics	PC with DM (n=78)	PC without DM (n=114)	p
Sex			0.12
Men	41 (52.6%)	68 (59.6%)
Women	37 (47.4%)	46 (40.4%)
Age, yr
Mean±SD	66.1±10.9	62.5±11.7	0.05
Initial symptom			0.40
Abdominal pain	39 (50.0%)	68 (59.6%)
Jaundice	29 (37.2%)	33 (28.9%)
Fatigue & weight loss	10 (12.8%)	13 (11.4%)
Smoking status			0.31
Current smoker	34 (43.6%)	44 (38.6%)
Ex- and non-smoker^∗	44 (56.4%)	70 (61.4%)
Alcohol intake			0.73
Chronic consumption	25 (32.1%)	34 (29.8%)
Social and non-drinking Body mass index, kg/m²	53 (67.9%)	80 (70.2%)
Mean±SD	23.5±4.0	22.8±2.7	0.19
Location of mass			0.61
Head	46 (59.0%)	63 (55.3%)
Body, tail, or both	27 (34.6%)	39 (34.2%)
Diffuse	5 (6.4%)	12 (10.5%)
Initial stage at diagnosis	0.89
II	5 (6.4%)	9 (7.9%)
III	23 (29.5%)	28 (24.6%)
IV	50 (64.1%)	77 (67.5%)
Curative resection	21 (26.9%)	28 (24.6%)	0.54
Hb (g/dL)	12.2±1.8	12.2±1.9	0.91
Albumin (g/dL)	3.8±0.6	3.8±0.5	0.85
Total cholesterol (mg/dL)	185.1±82.6	166.6±48.8	0.18
AST (IU/L)	65.1±86.2	68.9±108.5	0.31
ALT (IU/L)	89.5±144.6	86.8±170.2	0.34
Total bilirubin (mg/dL)	4.7±7.8	3.9±6.5	0.79
Alkaline phosphatase (IU/L)	235.6±250.2	249.3±362.1	0.04
LDL-C (mg/dL)	92.1±40.8	94.9±41.4	0.84
Triglyceride (mg/dL)	140.4±78.3	121.7±89.7	0.91
HbA1c (%)	7.4±1.7	5.9±0.8	0.01
CA 19-9 (U/mL)	2,453.6±6,118.0	9,016.7±1,2054.3	0.19

PC, pancreatic cancer; DM, diabetes mellitus; LDL-C, low-density lipoprotein cholesterol. All data represent mean±SD.

^∗ Ex-smoker means a patient who quitted smoking at least 5 years ago.

Table 2.

Duration of Diabetes in Patients with Pancreatic Cancer

Duration of diabetes (yr)	Patient numbers
0^∗	19 (24.4%)
＞0	59 (75.6%)
0-1	14 (23.7%)
1-2	15 (25.4%)
2-5	10 (16.9%)
5-10	9 (15.2%)
＞10	11 (18.6%)

PC, pancreatic cancer; DM, diabetes mellitus.

^∗ means that diabetic status was detected at the time of diagnosis on admission.

Table 3.

Comparison of Clinical Characteristics between Diabetic Patients with and without Pancreatic Cancer

Characteristics	DM with PC (n=78)	DM without PC (n=4,890)	p
Age, yr	66.4±10.9	64.6±12.7	0.16
Sex			0.65
Men	41 (52.6%)	2,760 (55.3%)
Women	37 (59.6%)	2,230 (44.7%)
Hb (g/dL)	12.2±1.8	12.8±2.2	0.18
Albumin (g/dL)	3.8±0.6	3.9±0.6	0.04
Total cholesterol (mg/dL)	185.1±82.6	174.4±48.9	0.06
AST (IU/L)	65.1±86.2	42.4±182.5	0.32
ALT (IU/L)	89.5±144.6	39.8±158.0	0.00
Total bilirubin (mg/dL)	4.7±7.8	0.9±1.6	0.00
Alkaline phosphatase (IU/L)	235.6±250.2	86.1±68.2	0.00
Triglyceride (mg/dL)	140.4±78.3	158.2±147.9	0.64
HbA1c (%)	7.4±1.7	7.9±2.0	0.37
CA 19-9 (U/mL)	2,453.6±6,118.0	29.2±41.0	0.00

PC, pancreatic cancer; DM, diabetes mellitus. All data (except sex) represent mean±SD.

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