Diabetes Mellitus in Children with Acute Recurrent and Chronic Pancreatitis: Data from the INSPPIRE Cohort

Melena D. Bellin, Mark Lowe, M. Bridget Zimmerman, Michael Wilschanski, Steven Werlin, David M. Troendle, Uzma Shah, Sarah J. Schwarzenberg, John F. Pohl, Emily Perito, Chee Yee Ooi, Jaimie D. Nathan, Veronique D. Morinville, Brian A. McFerron, Maria R. Mascarenhas, Asim Maqbool, Quin Liu, Tom K. Lin, Sohail Z. Husain, Ryan HimesMelvin B. Heyman, Tanja Gonska, Matthew J. Giefer, Cheryl E. Gariepy, Steven D. Freedman, Douglas S. Fishman, Bradley Barth, Maisam Abu-El-Haija, Aliye Uc

Research output: Contribution to journalArticle

Abstract

Objectives: Adults with chronic pancreatitis (CP) have a high risk for developing pancreatogenic diabetes mellitus (DM), but little is known regarding potential risk factors for DM in children with acute recurrent pancreatitis (ARP) or CP. We compared demographic and clinical features of children with ARP or CP, with and without DM, in the INternational Study Group of Pediatric Pancreatitis: In Search of a CuRE (INSPPIRE) registry. Methods: We reviewed the INSPPIRE database for the presence or absence of physician-diagnosed DM in 397 children, excluding those with total pancreatectomy with islet autotransplantation, enrolled from August 2012 to August 2017. Patient demographics, body mass index percentile, age at disease onset, disease risk factors, disease burden, and treatments were compared between children with DM (n = 24) and without DM (n = 373). Results: 24 children (6.0% of the cohort) had a diagnosis of DM. Five of 13 tested were positive for beta cell autoantibodies. The DM group was 4.2 years (95% CI 3.0, 5.4) older at first episode of acute pancreatitis, and tended to more often have hypertriglyceridemia (odds ratio (OR) 5.21 (1.33, 17.05)), coexisting autoimmune disease (OR 3.94 (0.88, 13.65)) or pancreatic atrophy (OR 3.64 (1.13, 11.59)). Conclusions: Pancreatic atrophy may be more common among children with DM, suggesting more advanced exocrine disease. However, data in this exploratory cohort also suggest increased autoimmunity and hypertriglyceridemia in children with DM, suggesting that risk factors for Type 1 and Type 2 DM respectively may play a role in mediating DM development in children with pancreatitis.

Original languageEnglish (US)
JournalJournal of pediatric gastroenterology and nutrition
DOIs
StateAccepted/In press - Jan 1 2019

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Chronic Pancreatitis
Diabetes Mellitus
Pancreatitis
Hypertriglyceridemia
Odds Ratio
Atrophy
Demography
Pancreatectomy
Autologous Transplantation
Child Development
Autoimmunity
Age of Onset
Autoantibodies
Type 2 Diabetes Mellitus
Autoimmune Diseases
Registries
Body Mass Index
Databases
Pediatrics
Physicians

Keywords

  • acute pancreatitis
  • hereditary pancreatitis
  • islet
  • pediatric pancreatitis

PubMed: MeSH publication types

  • Journal Article

Cite this

Diabetes Mellitus in Children with Acute Recurrent and Chronic Pancreatitis : Data from the INSPPIRE Cohort. / Bellin, Melena D.; Lowe, Mark; Zimmerman, M. Bridget; Wilschanski, Michael; Werlin, Steven; Troendle, David M.; Shah, Uzma; Schwarzenberg, Sarah J.; Pohl, John F.; Perito, Emily; Ooi, Chee Yee; Nathan, Jaimie D.; Morinville, Veronique D.; McFerron, Brian A.; Mascarenhas, Maria R.; Maqbool, Asim; Liu, Quin; Lin, Tom K.; Husain, Sohail Z.; Himes, Ryan; Heyman, Melvin B.; Gonska, Tanja; Giefer, Matthew J.; Gariepy, Cheryl E.; Freedman, Steven D.; Fishman, Douglas S.; Barth, Bradley; Abu-El-Haija, Maisam; Uc, Aliye.

In: Journal of pediatric gastroenterology and nutrition, 01.01.2019.

Research output: Contribution to journalArticle

Bellin, MD, Lowe, M, Zimmerman, MB, Wilschanski, M, Werlin, S, Troendle, DM, Shah, U, Schwarzenberg, SJ, Pohl, JF, Perito, E, Ooi, CY, Nathan, JD, Morinville, VD, McFerron, BA, Mascarenhas, MR, Maqbool, A, Liu, Q, Lin, TK, Husain, SZ, Himes, R, Heyman, MB, Gonska, T, Giefer, MJ, Gariepy, CE, Freedman, SD, Fishman, DS, Barth, B, Abu-El-Haija, M & Uc, A 2019, 'Diabetes Mellitus in Children with Acute Recurrent and Chronic Pancreatitis: Data from the INSPPIRE Cohort', Journal of pediatric gastroenterology and nutrition. https://doi.org/10.1097/MPG.0000000000002482
Bellin, Melena D. ; Lowe, Mark ; Zimmerman, M. Bridget ; Wilschanski, Michael ; Werlin, Steven ; Troendle, David M. ; Shah, Uzma ; Schwarzenberg, Sarah J. ; Pohl, John F. ; Perito, Emily ; Ooi, Chee Yee ; Nathan, Jaimie D. ; Morinville, Veronique D. ; McFerron, Brian A. ; Mascarenhas, Maria R. ; Maqbool, Asim ; Liu, Quin ; Lin, Tom K. ; Husain, Sohail Z. ; Himes, Ryan ; Heyman, Melvin B. ; Gonska, Tanja ; Giefer, Matthew J. ; Gariepy, Cheryl E. ; Freedman, Steven D. ; Fishman, Douglas S. ; Barth, Bradley ; Abu-El-Haija, Maisam ; Uc, Aliye. / Diabetes Mellitus in Children with Acute Recurrent and Chronic Pancreatitis : Data from the INSPPIRE Cohort. In: Journal of pediatric gastroenterology and nutrition. 2019.
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abstract = "Objectives: Adults with chronic pancreatitis (CP) have a high risk for developing pancreatogenic diabetes mellitus (DM), but little is known regarding potential risk factors for DM in children with acute recurrent pancreatitis (ARP) or CP. We compared demographic and clinical features of children with ARP or CP, with and without DM, in the INternational Study Group of Pediatric Pancreatitis: In Search of a CuRE (INSPPIRE) registry. Methods: We reviewed the INSPPIRE database for the presence or absence of physician-diagnosed DM in 397 children, excluding those with total pancreatectomy with islet autotransplantation, enrolled from August 2012 to August 2017. Patient demographics, body mass index percentile, age at disease onset, disease risk factors, disease burden, and treatments were compared between children with DM (n = 24) and without DM (n = 373). Results: 24 children (6.0{\%} of the cohort) had a diagnosis of DM. Five of 13 tested were positive for beta cell autoantibodies. The DM group was 4.2 years (95{\%} CI 3.0, 5.4) older at first episode of acute pancreatitis, and tended to more often have hypertriglyceridemia (odds ratio (OR) 5.21 (1.33, 17.05)), coexisting autoimmune disease (OR 3.94 (0.88, 13.65)) or pancreatic atrophy (OR 3.64 (1.13, 11.59)). Conclusions: Pancreatic atrophy may be more common among children with DM, suggesting more advanced exocrine disease. However, data in this exploratory cohort also suggest increased autoimmunity and hypertriglyceridemia in children with DM, suggesting that risk factors for Type 1 and Type 2 DM respectively may play a role in mediating DM development in children with pancreatitis.",
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author = "Bellin, {Melena D.} and Mark Lowe and Zimmerman, {M. Bridget} and Michael Wilschanski and Steven Werlin and Troendle, {David M.} and Uzma Shah and Schwarzenberg, {Sarah J.} and Pohl, {John F.} and Emily Perito and Ooi, {Chee Yee} and Nathan, {Jaimie D.} and Morinville, {Veronique D.} and McFerron, {Brian A.} and Mascarenhas, {Maria R.} and Asim Maqbool and Quin Liu and Lin, {Tom K.} and Husain, {Sohail Z.} and Ryan Himes and Heyman, {Melvin B.} and Tanja Gonska and Giefer, {Matthew J.} and Gariepy, {Cheryl E.} and Freedman, {Steven D.} and Fishman, {Douglas S.} and Bradley Barth and Maisam Abu-El-Haija and Aliye Uc",
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TY - JOUR

T1 - Diabetes Mellitus in Children with Acute Recurrent and Chronic Pancreatitis

T2 - Data from the INSPPIRE Cohort

AU - Bellin, Melena D.

AU - Lowe, Mark

AU - Zimmerman, M. Bridget

AU - Wilschanski, Michael

AU - Werlin, Steven

AU - Troendle, David M.

AU - Shah, Uzma

AU - Schwarzenberg, Sarah J.

AU - Pohl, John F.

AU - Perito, Emily

AU - Ooi, Chee Yee

AU - Nathan, Jaimie D.

AU - Morinville, Veronique D.

AU - McFerron, Brian A.

AU - Mascarenhas, Maria R.

AU - Maqbool, Asim

AU - Liu, Quin

AU - Lin, Tom K.

AU - Husain, Sohail Z.

AU - Himes, Ryan

AU - Heyman, Melvin B.

AU - Gonska, Tanja

AU - Giefer, Matthew J.

AU - Gariepy, Cheryl E.

AU - Freedman, Steven D.

AU - Fishman, Douglas S.

AU - Barth, Bradley

AU - Abu-El-Haija, Maisam

AU - Uc, Aliye

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: Adults with chronic pancreatitis (CP) have a high risk for developing pancreatogenic diabetes mellitus (DM), but little is known regarding potential risk factors for DM in children with acute recurrent pancreatitis (ARP) or CP. We compared demographic and clinical features of children with ARP or CP, with and without DM, in the INternational Study Group of Pediatric Pancreatitis: In Search of a CuRE (INSPPIRE) registry. Methods: We reviewed the INSPPIRE database for the presence or absence of physician-diagnosed DM in 397 children, excluding those with total pancreatectomy with islet autotransplantation, enrolled from August 2012 to August 2017. Patient demographics, body mass index percentile, age at disease onset, disease risk factors, disease burden, and treatments were compared between children with DM (n = 24) and without DM (n = 373). Results: 24 children (6.0% of the cohort) had a diagnosis of DM. Five of 13 tested were positive for beta cell autoantibodies. The DM group was 4.2 years (95% CI 3.0, 5.4) older at first episode of acute pancreatitis, and tended to more often have hypertriglyceridemia (odds ratio (OR) 5.21 (1.33, 17.05)), coexisting autoimmune disease (OR 3.94 (0.88, 13.65)) or pancreatic atrophy (OR 3.64 (1.13, 11.59)). Conclusions: Pancreatic atrophy may be more common among children with DM, suggesting more advanced exocrine disease. However, data in this exploratory cohort also suggest increased autoimmunity and hypertriglyceridemia in children with DM, suggesting that risk factors for Type 1 and Type 2 DM respectively may play a role in mediating DM development in children with pancreatitis.

AB - Objectives: Adults with chronic pancreatitis (CP) have a high risk for developing pancreatogenic diabetes mellitus (DM), but little is known regarding potential risk factors for DM in children with acute recurrent pancreatitis (ARP) or CP. We compared demographic and clinical features of children with ARP or CP, with and without DM, in the INternational Study Group of Pediatric Pancreatitis: In Search of a CuRE (INSPPIRE) registry. Methods: We reviewed the INSPPIRE database for the presence or absence of physician-diagnosed DM in 397 children, excluding those with total pancreatectomy with islet autotransplantation, enrolled from August 2012 to August 2017. Patient demographics, body mass index percentile, age at disease onset, disease risk factors, disease burden, and treatments were compared between children with DM (n = 24) and without DM (n = 373). Results: 24 children (6.0% of the cohort) had a diagnosis of DM. Five of 13 tested were positive for beta cell autoantibodies. The DM group was 4.2 years (95% CI 3.0, 5.4) older at first episode of acute pancreatitis, and tended to more often have hypertriglyceridemia (odds ratio (OR) 5.21 (1.33, 17.05)), coexisting autoimmune disease (OR 3.94 (0.88, 13.65)) or pancreatic atrophy (OR 3.64 (1.13, 11.59)). Conclusions: Pancreatic atrophy may be more common among children with DM, suggesting more advanced exocrine disease. However, data in this exploratory cohort also suggest increased autoimmunity and hypertriglyceridemia in children with DM, suggesting that risk factors for Type 1 and Type 2 DM respectively may play a role in mediating DM development in children with pancreatitis.

KW - acute pancreatitis

KW - hereditary pancreatitis

KW - islet

KW - pediatric pancreatitis

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DO - 10.1097/MPG.0000000000002482

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JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

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