Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis
IntroductionWithin 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 ri...
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Frontiers Media S.A.
2024-01-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1257222/full |
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author | Olga Julia Zahariev Olga Julia Zahariev Olga Julia Zahariev Stefania Bunduc Stefania Bunduc Adrienn Kovács Adrienn Kovács Dóra Demeter Dóra Demeter Luca Havelda Luca Havelda Bettina Csilla Budai Bettina Csilla Budai Dániel Sándor Veres Dániel Sándor Veres Nóra Hosszúfalusi Nóra Hosszúfalusi Bálint Mihály Erőss Bálint Mihály Erőss Bálint Mihály Erőss Brigitta Teutsch Brigitta Teutsch Márk Félix Juhász Márk Félix Juhász Péter Hegyi Péter Hegyi Péter Hegyi Péter Hegyi |
author_facet | Olga Julia Zahariev Olga Julia Zahariev Olga Julia Zahariev Stefania Bunduc Stefania Bunduc Adrienn Kovács Adrienn Kovács Dóra Demeter Dóra Demeter Luca Havelda Luca Havelda Bettina Csilla Budai Bettina Csilla Budai Dániel Sándor Veres Dániel Sándor Veres Nóra Hosszúfalusi Nóra Hosszúfalusi Bálint Mihály Erőss Bálint Mihály Erőss Bálint Mihály Erőss Brigitta Teutsch Brigitta Teutsch Márk Félix Juhász Márk Félix Juhász Péter Hegyi Péter Hegyi Péter Hegyi Péter Hegyi |
author_sort | Olga Julia Zahariev |
collection | DOAJ |
description | IntroductionWithin 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.MethodsWe 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).ResultsOf 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.DiscussionSevere 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. |
first_indexed | 2024-03-08T15:53:01Z |
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institution | Directory Open Access Journal |
issn | 2296-858X |
language | English |
last_indexed | 2024-03-08T15:53:01Z |
publishDate | 2024-01-01 |
publisher | Frontiers Media S.A. |
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series | Frontiers in Medicine |
spelling | doaj.art-ca702f3f3db74c5c8541804a602e24a52024-01-09T04:12:43ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-01-011010.3389/fmed.2023.12572221257222Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysisOlga Julia Zahariev0Olga Julia Zahariev1Olga Julia Zahariev2Stefania Bunduc3Stefania Bunduc4Adrienn Kovács5Adrienn Kovács6Dóra Demeter7Dóra Demeter8Luca Havelda9Luca Havelda10Bettina Csilla Budai11Bettina Csilla Budai12Dániel Sándor Veres13Dániel Sándor Veres14Nóra Hosszúfalusi15Nóra Hosszúfalusi16Bálint Mihály Erőss17Bálint Mihály Erőss18Bálint Mihály Erőss19Brigitta Teutsch20Brigitta Teutsch21Márk Félix Juhász22Márk Félix Juhász23Péter Hegyi24Péter Hegyi25Péter Hegyi26Péter Hegyi27Centre for Translational Medicine, Semmelweis University, Budapest, HungaryInstitute of Pancreatic Diseases, Semmelweis University, Budapest, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryCarol Davila University of Medicine and Pharmacy, Bucharest, RomaniaCentre for Translational Medicine, Semmelweis University, Budapest, HungaryDepartment of Internal Medicine and Hematology, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryDietetic Services, Central Hospital of Northern Pest - Military Hospital, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryInstitute of Pancreatic Diseases, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryInstitute of Pancreatic Diseases, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryDepartment of Biophysics and Radiation Biology, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryDepartment of Internal Medicine and Hematology, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryInstitute of Pancreatic Diseases, Semmelweis University, Budapest, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryHeim Pál National Pediatric Institute, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryInstitute of Pancreatic Diseases, Semmelweis University, Budapest, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryTranslational Pancreatology Research Group, Interdisciplinary Center of Excellence for Research Development and Innovation University of Szeged, Szeged, HungaryIntroductionWithin 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.MethodsWe 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).ResultsOf 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.DiscussionSevere 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.https://www.frontiersin.org/articles/10.3389/fmed.2023.1257222/fulldiabetes mellitusprediabetesacute pancreatitis (AP)pancreatitis—complicationsgastrointestinal disordersrisk factor (RF) |
spellingShingle | Olga Julia Zahariev Olga Julia Zahariev Olga Julia Zahariev Stefania Bunduc Stefania Bunduc Adrienn Kovács Adrienn Kovács Dóra Demeter Dóra Demeter Luca Havelda Luca Havelda Bettina Csilla Budai Bettina Csilla Budai Dániel Sándor Veres Dániel Sándor Veres Nóra Hosszúfalusi Nóra Hosszúfalusi Bálint Mihály Erőss Bálint Mihály Erőss Bálint Mihály Erőss Brigitta Teutsch Brigitta Teutsch Márk Félix Juhász Márk Félix Juhász Péter Hegyi Péter Hegyi Péter Hegyi Péter Hegyi Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis Frontiers in Medicine diabetes mellitus prediabetes acute pancreatitis (AP) pancreatitis—complications gastrointestinal disorders risk factor (RF) |
title | Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis |
title_full | Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis |
title_fullStr | Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis |
title_full_unstemmed | Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis |
title_short | Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis |
title_sort | risk factors for diabetes mellitus after acute pancreatitis a systematic review and meta analysis |
topic | diabetes mellitus prediabetes acute pancreatitis (AP) pancreatitis—complications gastrointestinal disorders risk factor (RF) |
url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1257222/full |
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