Abstract
Objectives:Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies.Methods:Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers. Questionnaires were completed by patients and physicians in a cross-sectional assessment. Patient demographics and disease characteristics were compared for CP with DM vs. without DM. Logistic regression was performed to assess the variables associated with DM diagnosis in a multivariable model.Results:Diabetics were more likely to be black (P=0.02), overweight, or obese (P<0.001), and with a family history of DM (P=0.0005). CP patients with DM were more likely to have pancreatic calcifications (63% vs. 54%, P=0.002), atrophy (44% vs. 32%, P<0.0001), and prior pancreas surgery (26.9% vs. 16.9%, P<0.0001). In multivariate logistic regression modeling, the strongest risk factors for DM were obesity (odds ratio (OR) 2.8, 95% confidence interval (CI) 1.9, 4.2) and exocrine insufficiency (OR 2.4, 95% CI 1.8, 3.2).Conclusions:In this large multicenter cohort of patients with CP, exocrine insufficiency, calcifications, and pancreas surgery conveyed higher odds of having DM. However, the traditional 'type 2 DM' risk factors of obesity and family history were similarly important in conveying risk for DM.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1457-1465 |
| Number of pages | 9 |
| Journal | American Journal of Gastroenterology |
| Volume | 112 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 1 2017 |
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Patient and Disease Characteristics Associated with the Presence of Diabetes Mellitus in Adults with Chronic Pancreatitis in the United States. / Bellin, Melena D; Whitcomb, David C.; Abberbock, Judah; Sherman, Stuart; Sandhu, Bimaljit S.; Gardner, Timothy B.; Anderson, Michelle A.; Lewis, Michele D.; Alkaade, Samer; Singh, Vikesh K.; Baillie, John; Banks, Peter A.; Conwell, Darwin; Cote, Gregory A.; Guda, Nalini M.; Muniraj, Thiruvengadam; Tang, Gong; Brand, Randall E.; Gelrud, Andres; Amann, Stephen T.; Forsmark, Christopher E.; Wilcox, C. Mel; Slivka, Adam; Yadav, Dhiraj.
In: American Journal of Gastroenterology, Vol. 112, No. 9, 01.09.2017, p. 1457-1465.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Patient and Disease Characteristics Associated with the Presence of Diabetes Mellitus in Adults with Chronic Pancreatitis in the United States
AU - Bellin, Melena D
AU - Whitcomb, David C.
AU - Abberbock, Judah
AU - Sherman, Stuart
AU - Sandhu, Bimaljit S.
AU - Gardner, Timothy B.
AU - Anderson, Michelle A.
AU - Lewis, Michele D.
AU - Alkaade, Samer
AU - Singh, Vikesh K.
AU - Baillie, John
AU - Banks, Peter A.
AU - Conwell, Darwin
AU - Cote, Gregory A.
AU - Guda, Nalini M.
AU - Muniraj, Thiruvengadam
AU - Tang, Gong
AU - Brand, Randall E.
AU - Gelrud, Andres
AU - Amann, Stephen T.
AU - Forsmark, Christopher E.
AU - Wilcox, C. Mel
AU - Slivka, Adam
AU - Yadav, Dhiraj
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Objectives:Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies.Methods:Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers. Questionnaires were completed by patients and physicians in a cross-sectional assessment. Patient demographics and disease characteristics were compared for CP with DM vs. without DM. Logistic regression was performed to assess the variables associated with DM diagnosis in a multivariable model.Results:Diabetics were more likely to be black (P=0.02), overweight, or obese (P<0.001), and with a family history of DM (P=0.0005). CP patients with DM were more likely to have pancreatic calcifications (63% vs. 54%, P=0.002), atrophy (44% vs. 32%, P<0.0001), and prior pancreas surgery (26.9% vs. 16.9%, P<0.0001). In multivariate logistic regression modeling, the strongest risk factors for DM were obesity (odds ratio (OR) 2.8, 95% confidence interval (CI) 1.9, 4.2) and exocrine insufficiency (OR 2.4, 95% CI 1.8, 3.2).Conclusions:In this large multicenter cohort of patients with CP, exocrine insufficiency, calcifications, and pancreas surgery conveyed higher odds of having DM. However, the traditional 'type 2 DM' risk factors of obesity and family history were similarly important in conveying risk for DM.
AB - Objectives:Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies.Methods:Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers. Questionnaires were completed by patients and physicians in a cross-sectional assessment. Patient demographics and disease characteristics were compared for CP with DM vs. without DM. Logistic regression was performed to assess the variables associated with DM diagnosis in a multivariable model.Results:Diabetics were more likely to be black (P=0.02), overweight, or obese (P<0.001), and with a family history of DM (P=0.0005). CP patients with DM were more likely to have pancreatic calcifications (63% vs. 54%, P=0.002), atrophy (44% vs. 32%, P<0.0001), and prior pancreas surgery (26.9% vs. 16.9%, P<0.0001). In multivariate logistic regression modeling, the strongest risk factors for DM were obesity (odds ratio (OR) 2.8, 95% confidence interval (CI) 1.9, 4.2) and exocrine insufficiency (OR 2.4, 95% CI 1.8, 3.2).Conclusions:In this large multicenter cohort of patients with CP, exocrine insufficiency, calcifications, and pancreas surgery conveyed higher odds of having DM. However, the traditional 'type 2 DM' risk factors of obesity and family history were similarly important in conveying risk for DM.
UR - http://www.scopus.com/inward/record.url?scp=85028821687&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028821687&partnerID=8YFLogxK
U2 - 10.1038/ajg.2017.181
DO - 10.1038/ajg.2017.181
M3 - Article
C2 - 28741615
AN - SCOPUS:85028821687
VL - 112
SP - 1457
EP - 1465
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 9
ER -