TY - JOUR
T1 - Multiple risk factors for diabetes mellitus in patients with chronic pancreatitis
T2 - A multicentre study of 1117 cases
AU - Olesen, Søren S
AU - Poulsen, Jakob L
AU - Novovic, Srdan
AU - Nøjgaard, Camilla
AU - Kalaitzakis, Evangelos
AU - Jensen, Nanna M
AU - Engjom, Trond
AU - Tjora, Erling
AU - Waage, Anne
AU - Hauge, Truls
AU - Haas, Stephan L
AU - Vujasinovic, Miroslav
AU - Barauskas, Giedrius
AU - Pukitis, Aldis
AU - Ozola-Zālīte, Imanta
AU - Okhlobystin, Alexey
AU - Parhiala, Mikael
AU - Laukkarinen, Johanna
AU - Drewes, Asbjørn M
PY - 2020/5
Y1 - 2020/5
N2 - BACKGROUND: Diabetes mellitus is a common complication of chronic pancreatitis. It is traditionally considered to develop as a consequence of beta cell loss, but there might be additional factors. Recent studies have highlighted the importance of type 2 diabetes-related risk factors in this context and population-based studies show increased risk of diabetes following acute pancreatitis. The aim of this study was to explore multiple risk factors for diabetes in patients with chronic pancreatitis.METHODS: We conducted a multicentre, cross-sectional study of patients with definitive chronic pancreatitis according to the M-ANNHEIM criteria. We used multivariable logistic regression models to determine risk factors independently associated with diabetes.RESULTS: The study included 1117 patients of whom 457 (40.9 %) had diabetes. The mean age was 52.8 ± 14.2 years and 67% were men. On multivariate analysis, parameters indicative of beta cell loss (pancreatic calcification, exocrine insufficiency, pancreatic resection) were confirmed as independent risk factors for diabetes (all p ≤ 0.02). In addition, type 2 diabetes-related risk factors (dyslipidaemia and overweight/obesity) were associated with the presence of diabetes (all p ≤ 0.002). Patients with a history of pancreatic fluid collections (indicative of previous attacks of acute pancreatitis) had a marginally increased risk of diabetes (p = 0.07).CONCLUSION: In patients with chronic pancreatitis the presence of diabetes is associated with multiple risk factors including type 2 diabetes-related factors. Our observations attest to the understanding of this entity and may have implications for treatment.
AB - BACKGROUND: Diabetes mellitus is a common complication of chronic pancreatitis. It is traditionally considered to develop as a consequence of beta cell loss, but there might be additional factors. Recent studies have highlighted the importance of type 2 diabetes-related risk factors in this context and population-based studies show increased risk of diabetes following acute pancreatitis. The aim of this study was to explore multiple risk factors for diabetes in patients with chronic pancreatitis.METHODS: We conducted a multicentre, cross-sectional study of patients with definitive chronic pancreatitis according to the M-ANNHEIM criteria. We used multivariable logistic regression models to determine risk factors independently associated with diabetes.RESULTS: The study included 1117 patients of whom 457 (40.9 %) had diabetes. The mean age was 52.8 ± 14.2 years and 67% were men. On multivariate analysis, parameters indicative of beta cell loss (pancreatic calcification, exocrine insufficiency, pancreatic resection) were confirmed as independent risk factors for diabetes (all p ≤ 0.02). In addition, type 2 diabetes-related risk factors (dyslipidaemia and overweight/obesity) were associated with the presence of diabetes (all p ≤ 0.002). Patients with a history of pancreatic fluid collections (indicative of previous attacks of acute pancreatitis) had a marginally increased risk of diabetes (p = 0.07).CONCLUSION: In patients with chronic pancreatitis the presence of diabetes is associated with multiple risk factors including type 2 diabetes-related factors. Our observations attest to the understanding of this entity and may have implications for treatment.
KW - acute pancreatitis
KW - Chronic pancreatitis
KW - diabetes mellitus
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85078258987&partnerID=8YFLogxK
U2 - 10.1177/2050640620901973
DO - 10.1177/2050640620901973
M3 - Journal article
C2 - 32213024
SN - 2050-6414
VL - 8
SP - 453
EP - 461
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 4
ER -