From the Department of Internal Medicine.
Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center.
Pancreas. 2021;50(5):696-703. doi: 10.1097/MPA.0000000000001818.
There is a paucity of studies evaluating predictors of new-onset diabetes mellitus (DM) after acute pancreatitis (AP-related DM). We used a population-based database to evaluate predictors of AP-related DM.
The Nationwide Readmissions Database (2010-2014) was used to identify all nondiabetic adults with an index primary diagnosis of AP. Multiple exclusions were applied to identify cohorts with and without AP-related DM. A case-control study was conducted to identify risk factors for developing AP-related DM within the calendar year.
We identified 2510 subjects with AP-related DM and 40,308 controls with AP who did not develop DM. Multivariable analysis revealed that increasing age (50-64 years; adjusted odds ratio [aOR], 1.35; 95% confidence interval [CI], 1.14-1.60), male sex (aOR, 1.2; 95% CI, 1.03-1.40), lowest income quartile (aOR, 1.48; 95% CI, 1.18-1.84), Elixhauser comorbidity index of 3 or higher (aOR, 1.47; 95% CI, 1.23-1.75), components of metabolic syndrome (aOR, 2.12; 95% CI, 1.21-3.70), severe AP (aOR, 1.60; 95% CI, 1.34-1.90), and recurrent AP (aOR, 1.46; 95% CI, 1.24-1.72) were independently associated with increased risk of AP-related DM.
These population-level variables predictive of developing AP-related DM can potentially identify patients who may benefit from closer follow-up, intensive education, and implementation of preventative strategies.
评估急性胰腺炎(AP 相关糖尿病)后新发糖尿病(DM)的预测因素的研究很少。我们使用基于人群的数据库来评估 AP 相关 DM 的预测因素。
使用全国再入院数据库(2010-2014 年)确定所有索引原发性 AP 诊断的非糖尿病成年人。进行了多项排除,以确定有和没有 AP 相关 DM 的队列。在日历年中进行病例对照研究,以确定发生 AP 相关 DM 的风险因素。
我们确定了 2510 名患有 AP 相关 DM 的患者和 40308 名患有 AP 但未发生 DM 的对照组患者。多变量分析显示,年龄增加(50-64 岁;调整后的优势比 [aOR],1.35;95%置信区间 [CI],1.14-1.60)、男性(aOR,1.2;95% CI,1.03-1.40)、最低收入四分位数(aOR,1.48;95% CI,1.18-1.84)、Elixhauser 合并症指数≥3(aOR,1.47;95% CI,1.23-1.75)、代谢综合征的组成部分(aOR,2.12;95% CI,1.21-3.70)、重症 AP(aOR,1.60;95% CI,1.34-1.90)和复发性 AP(aOR,1.46;95% CI,1.24-1.72)与 AP 相关 DM 的风险增加独立相关。
这些预测 AP 相关 DM 发展的人群水平变量可能可以识别出可能受益于更密切随访、强化教育和实施预防策略的患者。