New-onset prediabetes, diabetes after acute pancreatitis: A prospective cohort study with 12-month follow-up.

Autor: Akbar W; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Unnisa M; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Tandan M; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Murthy HVV; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Nabi Z; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Basha J; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Chavan R; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Lakhtakia S; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Ramchandani M; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Kalapala R; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Koutarapu C; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Gangdany ZM; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Reddy DN; Asian Institute of Gastroenterology, Hyderabad, 500 082, India., Talukdar R; Asian Institute of Gastroenterology, Hyderabad, 500 082, India. rup_talukdar@yahoo.com.; Wellcome DBT India Alliance Labs, Institute of Translational Research, Asian Healthcare Foundation, Hyderabad, 500 032, India. rup_talukdar@yahoo.com.
Jazyk: angličtina
Zdroj: Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology [Indian J Gastroenterol] 2022 Dec; Vol. 41 (6), pp. 558-566. Date of Electronic Publication: 2022 Dec 29.
DOI: 10.1007/s12664-022-01288-7
Abstrakt: Background: Acute pancreatitis (AP) is known to result in endocrine dysfunction (prediabetes, diabetes). The objective of this study was to determine the temporal incidence of endocrine dysfunction after onset of AP and determine the risk factors in Indian patients.
Methods: In this prospective study, enrolled patients diagnosed with AP between February 2019 and May 2019 were followed at 3, 6, and 12 months until May 2020. Patients with recurrent AP, chronic pancreatitis, and pre-existing endocrine dysfunction were excluded. Demographic and disease severity (clinical, laboratory, and radiological) data were recorded. Mann-Whitney U and Chi-square tests were used to compare groups. Temporal trend for development of endocrine dysfunction was evaluated using the Extended Mantel Haenszel Chi-square test for trend. Logistic regression was used to identify independent risk factors.
Results: Eighty-six patients (males 66, median [IQR] age 33.0 [26.0-44.2] years) who fulfilled enrolment criteria were finally analyzed. The most common etiology was alcohol (n=31 [36%]) followed by gallstones (n=17 [19.8%]). The proportion of patients with moderately severe acute pancreatitis and severe AP were 59.3% and 15.1%, respectively. Overall, the frequency of prediabetes and diabetes increased temporally across the follow-up period. These were 2 (2.33%) and 1 (1.16%) at 3 months, 11 (12.8%) and 5 (5.81%) at 6 months, and 20 (23.2%) and 9 (10.5%) at 1 year, respectively. On multivariable logistic regression, intervention for walled-off necrosis (WON) emerged as the single independent risk factor for endocrine dysfunction (odds ratio 9.01 [2.3-35.5]; p=0.002).
Conclusions: Endocrine dysfunction is frequent after an episode of AP. Intervention for WON is an independent risk factor for endocrine dysfunction.
(© 2022. Indian Society of Gastroenterology.)
Databáze: MEDLINE
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