TY - JOUR
T1 - Diabetes Mellitus in Children with Acute Recurrent and Chronic Pancreatitis
T2 - Data From the INternational Study Group of Pediatric Pancreatitis: In Search for a CuRE 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
N1 - Publisher Copyright:
© ESPGHAN and NASPGHAN. All rights reserved.
PY - 2019/11
Y1 - 2019/11
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 for 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, BMI 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: Twenty-four children (6% 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% confidence interval (CI) 3-5.4] 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)].CONCLUSION: 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 for 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, BMI 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: Twenty-four children (6% 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% confidence interval (CI) 3-5.4] 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)].CONCLUSION: 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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U2 - 10.1097/MPG.0000000000002482
DO - 10.1097/MPG.0000000000002482
M3 - Article
C2 - 31651815
AN - SCOPUS:85071738160
SN - 0277-2116
VL - 69
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
IS - 5
ER -
