Computed Tomography and Plasma Proteomics for Early Discrimination of Post-Pancreatitis Diabetes Mellitus.
BACKGROUND There is a lack of effective predictive methods for post-pancreatitis diabetes mellitus (PPDM-A) in clinical practice. This exploratory study aimed to identify candidate computed tomography (CT) and plasma proteomic features associated with subsequent PPDM-A and to assess their preliminary discriminatory performance. MATERIAL AND METHODS This retrospective single-center study compared CT imaging features and clinical data between post-pancreatitis normal glucose (PPNG-A, n=10) and PPDM-A (n=9) groups. Differential plasma protein expression was analyzed using proteomics. Correlations between CT features and protein features in patients with PPDM-A were also assessed. RESULTS The PPDM-A group showed higher incidences of pancreatic necrosis and elevated plasma complement factor I (CFI) levels compared with the PPNG-A group. Plasma coagulation factor XII (F12) and immunoglobulin heavy chain (IgH) levels were significantly decreased in the PPDM-A group. Enzyme-linked immunosorbent assay findings validated CFI; F12 and IgH remain proteomics-derived candidate markers. The combined 3-index model achieved an area under the curve of 0.989 for PPDM-A discrimination in the same discovery cohort. CFI was positively correlated with pancreatic necrosis (P=0.02, R=0.527). CONCLUSIONS Plasma CFI, F12, and IgH demonstrated potential predictive value for PPDM-A and may help identify at-risk patients. CFI and F12 were significantly correlated with pancreatic necrosis, suggesting a link between plasma molecular markers and imaging manifestations of PPDM-A. These exploratory findings provide a preliminary experimental basis for early discrimination of PPDM-A. Clinical utility requires confirmation in multicenter studies with larger sample sizes and both internal and external validation.
Authors
Hu Hu, Zeng Zeng, Li Li, Ma Ma, Yang Yang, Jiang Jiang, Li Li, Zhang Zhang, Yang Yang
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