Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
Diabetes Care. 2015 Jun;38(6):1089-98. doi: 10.2337/dc13-2983. Epub 2015 Jan 29.
To investigate whether the use of incretin-based drugs (GLP-1 receptor agonists and dipeptidyl peptidase 4 [DPP4] inhibitors) is associated with acute pancreatitis.
The study was a nationwide population-based case-control study using medical databases in Denmark. Participants were 12,868 patients with a first-time hospitalization for acute pancreatitis between 2005 and 2012 and a population of 128,680 matched control subjects. The main outcome measure was the odds ratio (OR) for acute pancreatitis associated with different antihyperglycemic drugs. We adjusted for history of gallstones, alcoholism, obesity, and other pancreatitis-associated comorbidities and medications.
A total of 89 pancreatitis patients (0.69%) and 684 control subjects (0.53%) were ever users of incretins. The crude OR for acute pancreatitis among incretin users was 1.36 (95% CI 1.08-1.69), while it was 1.44 (95% CI 1.34-1.54) among users of other antihyperglycemic drugs. After confounder adjustment, the risk of acute pancreatitis was not increased among incretin users (OR 0.95 [95% CI 0.75-1.21]), including DPP4 inhibitor users (OR 1.04 [95% CI 0.80-1.37]) or GLP-1 receptor agonist users (OR 0.82 [95% CI 0.54-1.23]), or among nonincretin antihyperglycemic drug users (OR 1.05 [95% CI 0.98-1.13]), compared with nonusers of any antihyperglycemic drugs. Findings were similar in current versus ever drug users and in patients with pancreatitis risk factors. The adjusted OR comparing incretin-based therapy with other antihyperglycemic therapy internally while also adjusting for diabetes duration and complications was 0.97 (95% CI 0.76-1.23).
Our findings suggest that the use of incretin-based drugs appears not to be associated with an increased risk of acute pancreatitis.
研究肠促胰岛素类药物（GLP-1 受体激动剂和二肽基肽酶 4 [DPP4] 抑制剂）的使用是否与急性胰腺炎有关。
本研究是一项基于人群的全国性病例对照研究，使用丹麦的医疗数据库。参与者为 2005 年至 2012 年间首次因急性胰腺炎住院的 12868 例患者和 128680 例匹配的对照人群。主要观察指标是不同抗高血糖药物与急性胰腺炎相关的比值比（OR）。我们调整了胆石症、酗酒、肥胖和其他与胰腺炎相关的合并症和药物的病史。
共有 89 例胰腺炎患者（0.69%）和 684 例对照者（0.53%）曾使用肠促胰岛素。肠促胰岛素使用者患急性胰腺炎的粗 OR 为 1.36（95%CI 1.08-1.69），而其他抗高血糖药物使用者的 OR 为 1.44（95%CI 1.34-1.54）。混杂因素调整后，肠促胰岛素使用者发生急性胰腺炎的风险并未增加（OR 0.95 [95%CI 0.75-1.21]），包括 DPP4 抑制剂使用者（OR 1.04 [95%CI 0.80-1.37]）或 GLP-1 受体激动剂使用者（OR 0.82 [95%CI 0.54-1.23]），或非肠促胰岛素抗高血糖药物使用者（OR 1.05 [95%CI 0.98-1.13]）与任何抗高血糖药物未使用者相比。在当前使用者与既往使用者以及在有胰腺炎危险因素的患者中，结果相似。在内部比较肠促胰岛素治疗与其他抗高血糖治疗的同时，还调整了糖尿病病程和并发症，调整后的 OR 为 0.97（95%CI 0.76-1.23）。
我们的研究结果表明，肠促胰岛素类药物的使用似乎与急性胰腺炎的风险增加无关。
