Abstract
OBJECTIVE Diabetes that arises from chronic pancreatitis (CP) is associated with increased morbidity and mortality. Methods to predict which patients with CP are at great-est risk for diabetes are urgently needed. We aimed to examine independent risk factors for diabetes in a large cohort of patients with CP. RESEARCH DESIGN AND METHODS This cross-sectional study comprised 645 individuals with CP enrolled in the PROCEED study, of whom 276 had diabetes. We conducted univariable and multivariable regression analyses of potential risk factors for diabetes. Model performance was assessed by area under the receiver operating characteristic curve (AUROC) analysis, and accuracy was evaluated by cross validation. Exploratory analyses were stratified according to the timing of development of diabetes relative to the diagnosis of pancreatitis. RESULTS Independent correlates of diabetes in CP included risk factors for type 2 diabetes (older age, overweight/obese status, male sex, non-White race, tobacco use) as well as pancreatic disease–related factors (history of acute pancreatitis complications, nonalcoholic etiology of CP, exocrine pancreatic dysfunction, pancreatic calcification, pancreatic atrophy) (AUROC 0.745). Type 2 diabetes risk factors were predominant for diabetes occurring before pancreatitis, and pancreatic disease–related factors were predominant for diabetes occurring after pancreatitis. CONCLUSIONS Multiple factors are associated with diabetes in CP, including canonical risk factors for type 2 diabetes and features associated with pancreatitis severity. This study lays the groundwork for the future development of models integrating clinical and nonclinical data to identify patients with CP at risk for diabetes and identifies modifiable risk factors (obesity, smoking) on which to focus for diabetes prevention.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 46-55 |
| Number of pages | 10 |
| Journal | Diabetes care |
| Volume | 46 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2023 |
Bibliographical note
Funding Information:Acknowledgments. The authors thank all the individuals who volunteered to participate in PROCEED. Funding. The research reported in this article was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and National Cancer Institute under award numbers U01DK108327 (P.A.H., D.L.C.), U01DK108288 (S.S.V.), U01DK108323 (E.L.F.), U01DK108326 (W.E.F.), U01DK108328 (L.L., Y.Y.), U01DK108300 (W.G.P.), U01DK108314 (M.O.G.), U01DK108320 (C.E.F.), U01DK126300 (M.D.B.), U01DK108332 (S.K.V.), and U01DK108306 (D.C.W., D.Y.). M.O.G. was supported by the Eris M. Field Chair in Diabetes Research and NIDDK grant P30DK063491.
Funding Information:
The PROCEED study is an ongoing, mul ticenter, longitudinal cohort study of CP in the U.S. (ClinicalTrials.gov identifier: NCT03099850) sponsored by the National Institutes of Health (18). The study was approved by the institutional review boards of each of the participating institutions and the coordinating and data management center of the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC). Informed consent was provided by participants before any study procedures.
Publisher Copyright:
© 2022 by the American Diabetes Association.
PubMed: MeSH publication types
- Journal Article
- Research Support, N.I.H., Extramural
- Research Support, Non-U.S. Gov't
