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Authors
Abstract(s)
Introdução: A diabetes mellitus e o adenocarcinoma ductal do pâncreas são duas
patologias que, além de partilharem o seu órgão de ação, o pâncreas, e de serem associadas
a uma elevada morbimortalidade mundial, possuem, presumivelmente, uma íntima relação,
causal e bidirecional, entre elas. Contudo, os mecanismos responsáveis por esta interação
de dois sentidos continuam escassamente elucidados e, consequentemente, as
oportunidades de prevenção, que esta associação pode permitir, continuam por explorar.
Objetivos: Esta dissertação visou analisar a relação causal bidirecional da diabetes
mellitus com o adenocarcinoma ductal do pâncreas e, com base nos dados obtidos,
averiguar a existência de possíveis oportunidades diagnósticas, de prevenção e de deteção
precoce, subjacentes a esta correspondência.
Métodos: Para a realização desta dissertação, procedeu-se a duas pesquisas bibliográficas
de artigos científicos, ambas nas plataformas PubMed, Scopus e Nature. Para a primeira
pesquisa utilizaram-se as seguintes palavras-chave: pancreatic adenocarcinoma AND
(diabetes OR hyperglycemia) AND risk factor. Já para a segunda pesquisa bibliográfica
utilizaram-se as palavras-chave: pancreatic adenocarcinoma AND (diabetes OR
hyperglycemia) AND (screening OR prevention).
Resultados: Foram analisados 17 artigos que abordaram a relação entre a diabetes
mellitus e o adenocarcinoma do pâncreas e os possíveis mecanismos fisiopatológicos
responsáveis. Verificou-se um risco quase duas vezes superior de adenocarcinoma do
pâncreas nos diabéticos, por processos inflamatórios, metabólicos e mutacionais, e uma
prevalência de diabetes de quase 70% no adenocarcinoma do pâncreas, sugerindo um
fenómeno paraneoplásico. Posteriormente, foram analisados 14 artigos que exploraram o
leque de oportunidades de prevenção e diagnóstico precoce que a relação dissecada nesta
dissertação possibilita, como biomarcadores sanguíneos, ferramentas de apoio à decisão
clínica, modelos de predição de risco, testes poligénicos preditivos e nanotecnologia.
Conclusão: Constatou-se, efetivamente, uma dualidade de sentidos da relação entre a
diabetes mellitus e o adenocarcinoma do pâncreas, por mecanismos metabólicos,
inflamatórios, proteómicos e de sinalização. Deste modo, é imperativo estudar e usufruir
das oportunidades de prevenção que esta associação fornece e preencher as lacunas na
investigação deste tema, com um maior acompanhamento longitudinal e maiores amostras.
Introduction: Diabetes mellitus and pancreatic ductal adenocarcinoma are two pathologies that, in addition to sharing their organ of action, the pancreas, and being associated with a high worldwide morbidity and mortality, may have a causal and bidirectional relationship between them. However, the mechanisms responsible for this two-way interaction remain poorly elucidated and, consequently, the prevention opportunities that this association may allow remain unexplored. Objectives: This dissertation aims to analyze the bidirectional causal relationship between diabetes mellitus and pancreatic ductal adenocarcinoma and, based on the data found, to investigate the existence of possible diagnostic, preventive and early detection opportunities underlying this correspondence. Methods: This dissertation was based on two bibliographical searches of scientific articles, both on the PubMed, Scopus and Nature platforms. For the first search the following keywords were used: pancreatic adenocarcinoma AND (diabetes OR hyperglycemia) AND risk factor. For the second bibliographical search, the keywords used were: pancreatic adenocarcinoma AND (diabetes OR hyperglycemia) AND (screening OR prevention). Results: 17 articles were analyzed that addressed the two-way relationship between diabetes mellitus and pancreatic ductal adenocarcinoma and the possible pathophysiological mechanisms responsible. There was an almost twice as high risk of pancreatic adenocarcinoma in diabetics, due to inflammatory, metabolic and mutational processes, and a prevalence of diabetes of almost 70% in pancreatic adenocarcinoma, suggesting a paraneoplastic phenomenon. Subsequently, 14 articles were analyzed that explored the range of opportunities for prevention and early diagnosis that the relationship dissected in this dissertation allows, such as blood biomarkers, clinical decision support tools, risk prediction models, predictive polygenic tests and nanotechnology. Conclusion: A duality of meanings was effectively found in the relationship between diabetes mellitus and pancreatic adenocarcinoma, through metabolic, inflammatory, proteomic and signaling mechanisms. Therefore, it is imperative to study and take advantage of the prevention opportunities that this association offers and fill the gaps in research on this topic, with greater longitudinal monitoring and larger samples.
Introduction: Diabetes mellitus and pancreatic ductal adenocarcinoma are two pathologies that, in addition to sharing their organ of action, the pancreas, and being associated with a high worldwide morbidity and mortality, may have a causal and bidirectional relationship between them. However, the mechanisms responsible for this two-way interaction remain poorly elucidated and, consequently, the prevention opportunities that this association may allow remain unexplored. Objectives: This dissertation aims to analyze the bidirectional causal relationship between diabetes mellitus and pancreatic ductal adenocarcinoma and, based on the data found, to investigate the existence of possible diagnostic, preventive and early detection opportunities underlying this correspondence. Methods: This dissertation was based on two bibliographical searches of scientific articles, both on the PubMed, Scopus and Nature platforms. For the first search the following keywords were used: pancreatic adenocarcinoma AND (diabetes OR hyperglycemia) AND risk factor. For the second bibliographical search, the keywords used were: pancreatic adenocarcinoma AND (diabetes OR hyperglycemia) AND (screening OR prevention). Results: 17 articles were analyzed that addressed the two-way relationship between diabetes mellitus and pancreatic ductal adenocarcinoma and the possible pathophysiological mechanisms responsible. There was an almost twice as high risk of pancreatic adenocarcinoma in diabetics, due to inflammatory, metabolic and mutational processes, and a prevalence of diabetes of almost 70% in pancreatic adenocarcinoma, suggesting a paraneoplastic phenomenon. Subsequently, 14 articles were analyzed that explored the range of opportunities for prevention and early diagnosis that the relationship dissected in this dissertation allows, such as blood biomarkers, clinical decision support tools, risk prediction models, predictive polygenic tests and nanotechnology. Conclusion: A duality of meanings was effectively found in the relationship between diabetes mellitus and pancreatic adenocarcinoma, through metabolic, inflammatory, proteomic and signaling mechanisms. Therefore, it is imperative to study and take advantage of the prevention opportunities that this association offers and fill the gaps in research on this topic, with greater longitudinal monitoring and larger samples.
Description
Keywords
Adenocarcinoma do Pâncreas Cancro do Pâncreas Diabetes Mellitus Fator de Risco Hiperglicemia Prevenção