Department of Endocrinology and Metabolism, University of Health Sciences, Kecioren Training and Research Hospital, Turkey.
Department of Internal Medicine, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Turkey.
Postgrad Med. 2022 Sep;134(7):711-716. doi: 10.1080/00325481.2022.2105613. Epub 2022 Jul 28.
We aimed to determine the effect of diabetes mellitus (DM) on the severity of acute pancreatitis (AP) and whether diabetes is a predictor of severe acute pancreatitis (SAP). A total of 181 patients diagnosed with a first attack of AP in our hospital were retrospectively evaluated. AP severity was evaluated and compared between diabetic and non-diabetic patients. Independent factors predicting SAP were identified with a binary logistic regression model. Of the 164 patients [108 (65.9%) women, 56 (34.1%) men] enrolled in the study, 35 patients (21.3%) had been diagnosed with DM, while 129 (78.7%) did not have DM. SAP, necrotizing pancreatitis, and local complications were observed to be more common among diabetic patients compared to non-diabetic patients (all < 0.001), while the incidences of systemic complications and transient or persistent organ failure were similar between the groups. The incidences of DM and cancer were higher in the SAP group ( < 0.001 and = 0.033, respectively). The presence of DM (OR: 3.246, 95% CI: 1.278-8.244, = 0.013), high (≥3) Ranson score (OR: 3.529, 95% CI: 1.342-9.280, = 0.011), and high maximum C-reactive protein level (OR: 1.005, 95% CI: 1.001-1.010, = 0.046) were independent risk factors predicting SAP. DM is both a risk factor for SAP and an independent predictor of SAP. Evaluation of the presence of DM at the time of diagnosis can help predict SAP in a considerably early phase.
我们旨在确定糖尿病(DM)对急性胰腺炎(AP)严重程度的影响,以及糖尿病是否是重症急性胰腺炎(SAP)的预测因素。回顾性评估了我院收治的 181 例首次确诊为 AP 的患者。评估并比较了糖尿病和非糖尿病患者的 AP 严重程度。采用二元逻辑回归模型确定预测 SAP 的独立因素。在纳入研究的 164 例患者[108 例(65.9%)女性,56 例(34.1%)男性]中,35 例(21.3%)被诊断为 DM,而 129 例(78.7%)没有 DM。与非糖尿病患者相比,糖尿病患者 SAP、坏死性胰腺炎和局部并发症更为常见(均<0.001),而两组全身并发症和短暂或持续器官衰竭的发生率相似。SAP 组 DM 和癌症的发生率较高(<0.001 和=0.033)。DM 的存在(OR:3.246,95%CI:1.278-8.244,=0.013)、高(≥3)Ranson 评分(OR:3.529,95%CI:1.342-9.280,=0.011)和高最大 C 反应蛋白水平(OR:1.005,95%CI:1.001-1.010,=0.046)是预测 SAP 的独立危险因素。DM 既是 SAP 的危险因素,也是 SAP 的独立预测因素。在诊断时评估 DM 的存在有助于在相当早的阶段预测 SAP。