The Population-Level Prevalence of Exocrine Pancreas Insufficiency and the Subsequent Risk of Pancreatic Cancer.

Autor:	Babajide O; From the Department of Gastroenterology and Hepatology, New York Medical College/Metropolitan Hospital Program, New York, NY., Desai A; Department of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH., Eruchalu C; University of Central Florida, Orlando, FL., Sedarous M; Division of Gastroenterology, Kingston Health Sciences Centre, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada., Adekunle AD; Division of Gastroenterology, Washington University School of Medicine, St Louis, MO., Youssef M; Division of Internal Medicine, University of Toronto, Toronto, Ontario, Canada., Mahmud M; Division of Internal Medicine, Midwestern University, Verde Valley Internal Medicine Program, Glendale, AZ., Okafor PN; Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL.
Jazyk:	angličtina
Zdroj:	Pancreas [Pancreas] 2024 Oct 01; Vol. 53 (9), pp. e723-e728. Date of Electronic Publication: 2024 Apr 30.
DOI:	10.1097/MPA.0000000000002359
Abstrakt:	Objectives: The aim of this study was to study the prevalence of exocrine pancreas insufficiency (EPI) at a population level and the subsequent risk of pancreatic ductal adenocarcinoma (PDAC). Materials and Methods: Using TriNetX (a database of over 79 million US residents), we included patients ≥18 years with EPI (identified via ICD-10 codes) and continuous follow-up from 2016-2022. Patients with prior pancreas resection and PDAC before an EPI diagnosis were excluded. The primary outcome was EPI prevalence. Secondary outcomes included imaging utilization, PDAC risk, and pancreatic enzyme replacement therapy (PERT) utilization. We performed 1:1 propensity score matching (PSM) of patients with EPI versus patients without an EPI diagnosis. Results: The population prevalence of EPI was 0.8% (n = 24,080) with a mean age of 55.6 years. After PSM, PDAC risk among patients with EPI was twice as high compared with patients without EPI (aHR, 1.97; 95% CI, 1.66-2.36). This risk persisted even after excluding patients with a history of acute or chronic pancreatitis (adjusted odds ratio, 4.25; 95% CI, 2.99-6.04). Only 58% (n = 13, 390) of patients with EPI received PERT. No difference was observed in PDAC risk between patients with EPI on PERT and those not on PERT (aHR, 1.10; 95% CI, 0.95-1.26; P = 0.17). Conclusions: Despite a low prevalence, patients with EPI may have a higher risk of PDAC, and majority with EPI were not on PERT. PERT did not impact incident PDAC risk after an EPI diagnosis. Competing Interests: The authors declare no conflict of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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