Liao Kuan-Fu, Lin Cheng-Li, Lai Shih-Wei, Chen Wen-Chi
College of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
College of Medicine, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Eur J Intern Med. 2016 Jan;27:76-9. doi: 10.1016/j.ejim.2015.09.015. Epub 2015 Oct 1.
There is still lack of definite evidence to establish the association between sitagliptin use and acute pancreatitis. The study aimed to test this issue in Taiwan.
This case-control study was designed to analyze the database of the Taiwan National Health Insurance Program. There were 349 subjects with type 2 diabetes mellitus aged 20-84 with a first-attack of acute pancreatitis from 2009 to 2011 as the case group and 1116 randomly selected subjects with type 2 diabetes mellitus without acute pancreatitis as the control group. Both groups were matched with sex, age, comorbidities, and index year of diagnosing acute pancreatitis. Current use of sitagliptin was defined as subjects who had their last tablet of sitagliptin ≤7 days before the date of diagnosing acute pancreatitis. Late use of sitagliptin was defined as subjects who had their last tablet of sitagliptin between 8 and 30 days before the date of diagnosing acute pancreatitis. Never use of sitagliptin was defined as subjects who never had a sitagliptin prescription. The risk of acute pancreatitis associated with sitagliptin use was estimated by the odds ratio (OR) and 95% confidence interval (CI) using the multivariable logistic regression model.
After statistical correction for potential confounders, the adjusted OR of acute pancreatitis was 2.47 for subjects with current use of sitagliptin (95% CI 0.84, 7.28), when compared with those never using sitagliptin, but without statistical significance. The adjusted OR decreased to 1.14 for subjects with late use of sitagliptin (95% CI 0.66, 1.98), but without statistical significance.
No significant association is detected between sitagliptin use and acute pancreatitis in type 2 diabetes mellitus.
仍缺乏确凿证据来证实使用西他列汀与急性胰腺炎之间的关联。本研究旨在在台湾验证这一问题。
本病例对照研究旨在分析台湾全民健康保险计划的数据库。选取2009年至2011年间首次发作急性胰腺炎的349例年龄在20 - 84岁的2型糖尿病患者作为病例组，随机选取1116例无急性胰腺炎的2型糖尿病患者作为对照组。两组在性别、年龄、合并症以及急性胰腺炎诊断索引年份方面进行匹配。当前使用西他列汀定义为在诊断急性胰腺炎日期前≤7天服用过最后一剂西他列汀的受试者。近期使用西他列汀定义为在诊断急性胰腺炎日期前8至30天服用过最后一剂西他列汀的受试者。从未使用西他列汀定义为从未有过西他列汀处方的受试者。使用多变量逻辑回归模型通过比值比（OR）和95%置信区间（CI）估计使用西他列汀与急性胰腺炎相关的风险。
在对潜在混杂因素进行统计学校正后，与从未使用西他列汀的受试者相比，当前使用西他列汀的受试者急性胰腺炎的校正OR为2.47（95%CI 0.84，7.28），但无统计学意义。近期使用西他列汀的受试者校正OR降至1.14（95%CI 0.66，1.98），但无统计学意义。
在2型糖尿病患者中，未检测到使用西他列汀与急性胰腺炎之间存在显著关联。
