Cozma Matei-Alexandru, Dobrică Elena-Codruta, Shah Purva, Shellah Duha, Găman Mihnea-Alexandru, Diaconu Camelia Cristina
Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Gastroenterology, Colentina Clinical Hospital, 020125 Bucharest, Romania.
Healthcare (Basel). 2022 Nov 2;10(11):2196. doi: 10.3390/healthcare10112196.
Type 2 diabetes mellitus (T2DM) has been associated with higher rates and poorer prognosis of infections, mainly due to poor glycemic control, reduced response of T-cells and neutrophils, and impaired migration, phagocytosis, and chemotaxis of leukocytes. However, the impact of T2DM on acute cholangitis (AC) has not been assessed so far. Thus, we aimed to explore this association by means of a systematic review of the literature.
This systematic review was carried out based on the recommendations stated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed/MEDLINE, Web of Science and SCOPUS databases to identify relevant publications depicting an association between T2DM and AC from the inception of these search services up to present.
We detected a total of 435 eligible records. After we applied the inclusion and exclusion criteria, a total of 14 articles were included in the present systematic review. Included manuscripts focused on the potential role of T2DM as a risk factor for the development of AC and on its contribution to a worse prognosis in AC, e.g., development of sepsis or other complications, the risk of AC recurrence and the impact on mortality.
As compared to non-diabetic individuals, patients with T2DM have a higher risk of AC as a complication of choledocholithiasis or gallstone pancreatitis. Several oral hypoglycemic drugs used in the management of T2DM may also be involved in the onset of AC. Diabetic patients who suffer from AC have a higher likelihood of longer hospital stays and sepsis, as well as a higher risk of mortality and more severe forms of AC as compared to non-diabetic individuals.
2型糖尿病（T2DM）与感染率升高及预后较差相关，主要原因是血糖控制不佳、T细胞和中性粒细胞反应降低以及白细胞迁移、吞噬作用和趋化性受损。然而，T2DM对急性胆管炎（AC）的影响迄今尚未得到评估。因此，我们旨在通过对文献的系统评价来探讨这种关联。
本系统评价是根据系统评价和Meta分析的首选报告项目（PRISMA）指南中所述的建议进行的。我们检索了PubMed/MEDLINE、科学引文索引和Scopus数据库，以识别从这些检索服务开始至今描述T2DM与AC之间关联的相关出版物。
我们共检测到435条符合条件的记录。在应用纳入和排除标准后，本系统评价共纳入14篇文章。纳入的手稿重点关注T2DM作为AC发生的危险因素的潜在作用及其对AC预后较差的影响，例如脓毒症或其他并发症的发生、AC复发的风险以及对死亡率的影响。
与非糖尿病个体相比，T2DM患者作为胆总管结石或胆石性胰腺炎并发症发生AC的风险更高。用于治疗T2DM的几种口服降糖药也可能与AC的发病有关。与非糖尿病个体相比，患有AC的糖尿病患者住院时间更长且发生脓毒症的可能性更高，以及死亡风险更高且AC病情更严重。
