Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis.
Front Med (Lausanne)
; 10: 1257222, 2023.
Article
em En
| MEDLINE
| ID: mdl-38264039
ABSTRACT
Introduction:
Within 5 years of having acute pancreatitis (AP), approximately 20% of patients develop diabetes mellitus (DM), which later increases to approximately 40%. Some studies suggest that the prevalence of prediabetes (PD) and/or DM can grow as high as 59% over time. However, information on risk factors is limited. We aimed to identify risk factors for developing PD or DM following AP.Methods:
We systematically searched three databases up to 4 September 2023 extracting direct, within-study comparisons of risk factors on the rate of new-onset PD and DM in AP patients. When PD and DM event rates could not be separated, we reported results for this composite outcome as PD/DM. Meta-analysis was performed using the random-effects model to calculate pooled odds ratios (OR) with 95% confidence intervals (CI).Results:
Of the 61 studies identified, 50 were included in the meta-analysis, covering 76,797 participants. The studies reported on 79 risk factors, and meta-analysis was feasible for 34 risk factor and outcome pairs. The odds of developing PD/DM was significantly higher after severe and moderately severe AP (OR 4.32; CI 1.76-10.60) than mild AP. Hypertriglyceridemic AP etiology (OR 3.27; CI 0.17-63.91) and pancreatic necrosis (OR 5.53; CI 1.59-19.21) were associated with a higher risk of developing PD/DM. Alcoholic AP etiology (OR 1.82; CI 1.09-3.04), organ failure (OR 3.19; CI 0.55-18.64), recurrent AP (OR 1.89; CI 0.95-3.77), obesity (OR 1.85; CI 1.43-2.38), chronic kidney disease (OR 2.10; CI 1.85-2.38), liver cirrhosis (OR 2.48; CI 0.18-34.25), and dyslipidemia (OR 1.82; CI 0.68-4.84) were associated with a higher risk of developing DM.Discussion:
Severe and moderately severe AP, alcoholic and hypertriglyceridemic etiologies, pancreatic necrosis, organ failure, recurrent acute pancreatitis and comorbidities of obesity, chronic kidney disease liver disease, and dyslipidemia are associated with a higher risk of developing PD or DM. Systematic review registration https//www.crd.york.ac.uk/prospero/, identifier CRD42021281983.
Texto completo:
1
Base de dados:
MEDLINE
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Idioma:
En
Revista:
Front Med (Lausanne)
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Hungria