Súvislosti medzi diabetes mellitus (DM) a karcinómom pankreasu zatiaľ nie sú jednoznačne objasnené. V našej práci sme chceli overiť, či pacienti s karcinómom pankreasu majú štatisticky významne nižšiu hladinu C-peptidu v priebehu orálneho glukózového tolerančného testu (oGTT) oproti kontrolnej skupine, bez ohľadu na súčasnú diagnózu diabetes mellitus, keďže takýchto štúdií bolo zatiaľ publikovaných málo. Metódy: V našej práci sme analyzovali hodnoty C-peptidu v 120 min oGTT u 29 pacientov s karcinómom pankreasu a 23 pacientov s chronickou pankreatitídou – kontrolný súbor. Výsledky: Hodnoty C-peptidu v 120 min oGTT u pacientov s karcinómom pankreasu neboli nižšie ako u kontrolného súboru, rozdiel nebol štatisticky významný (p = 0,257). Pomocou oGTT sme u 15 (51 %) pacientov s karcinómom pankreasu a u deviatich (39 %) pacientov v kontrolnej skupine zistili DM. Nezistili sme štatisticky významný rozdiel v hladinách C-peptidu u pacientov s DM a bez neho u pacientov s karcinómom pankreasu (p = 0,383) ani u pacientov s chronickou pankreatitídou (p = 0,877). Záver: Nepotvrdili sme nižšie hodnoty C-peptidu počas oGTT u pacientov s karcinómom pankreasu v porovnaní s kontrolným súborom. Pre posúdenie významu súvislostí diabetes mellitus a karcinómu pankreasu v diagnostike karcinómu sú potrebné ďalšie štúdie s väčším počtom pacientov. Kľúčové slová: karcinóm pankreasu – diabetes mellitus – C-peptid

The mechanism responsible for diabetes mellitus (DM) in patients with pancreatic cancer remains controversial. The aim of our study is to verify that pancreatic cancer patients had lower C-peptide levels during an oral glucose tolerance test (oGTT) than the control subjects, regardless of the presence of diabetes mellitus, since until now only a few similar studies have been published. Methods: In our study we analysed C-peptide response at 120 minutes during the oGTT in 29 patients with pancreatic cancer and 23 patients with chronic pancreatitis – control subjects. Results: C-peptide levels, observed at 120 minutes during the oGTT in patients with pancreatic cancer, were not lower than those of control subjects, and the difference was not statistically significant (p = 0.257). By means of the oGTT, we detected diabetes mellitus in 15 (51%) patients in the pancreatic cancer group and in nine (39%) control subjects. There were no statistically significant differences in C-peptide levels in patients with and without DM, or in the pancreatic cancer group (p = 0.383) or in control subjects with chronic pancreatitis (p = 0.877). Conclusions: We did not confirm that a characteristic feature of pancreatic cancer patients is decreased C-peptide production during the oGTT in comparison with the control subjects. Further studies are needed in a large number of patients to assess the importance of impaired glucose tolerance or diabetes mellitus in pancreatic cancer detection. Key words: pancreatic cancer – diabetes mellitus – C-peptide The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers. Submitted: 14. 4. 2014 Accepted: 26. 5. 2014

Gastroenterologická klinika SZU a UNB UN sv Cyrila a Metoda Bratislava

Determination of C-peptide levels during a glucose tolerance test in patients with pancreatic cancer