Number of recurrences is significantly associated with the post-acute pancreatitis diabetes mellitus in a population with hypertriglyceridemic acute pancreatitis

Tu, Xiamin; Liu, Qingxie; Chen, Lin; Liu, Jie; Xiao-ping, YU; Jiao, Xiuping; Wang, Ningzhi; Hu, Liang‐Hao; Yuan, Yuan; Gong, Weijuan; Ding, Yanbing; Shi, Xiaolei; Xiao, Weiming; Lu, Guotao

doi:10.1186/s12944-023-01840-0

Cited by 6 publications

(5 citation statements)

References 35 publications

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“…We observed a near statistically significant increased odds of DM [OR: 1.89; CI: 0.95–3.77; Figure 6A ; ( 4 , 20 , 29 , 35–37 , 41–43 , 50 )] and PD/DM [OR: 1.72; CI: 0.92–3.20; Figure 6B ; ( 23 , 27 , 29 , 33 , 47 )] recurrent acute pancreatitis (RAP) compared to a single AP episode. Subgroup analysis for follow-up length found no effect of time; however, few studies made up each subgroup.…”

Section: Resultsmentioning

confidence: 85%

“…Some studies explored the effect of different numbers of AP episodes. Three or more episodes of AP were associated with a near statistically significant increased odds of DM [OR: 2.53; CI: 0.95–6.74; ( 4 , 20 , 41 )] compared to having one or two AP episodes ( Supplementary Figure S10 ).…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, elevated glucose levels during hospitalization are associated with more severe AP episodes and increased mortality rates ( 3 ). Moreover, it is gaining recognition that DM might also develop after AP as a potential long-term complication ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis

Zahariev,

Bunduc,

Kovács

et al. 2024

Front. Med.

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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.

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Section: Resultsmentioning

confidence: 85%

Section: Resultsmentioning

confidence: 99%

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Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis

Zahariev,

Bunduc,

Kovács

et al. 2024

Front. Med.

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“…The risk of PPDM-A increases with increasing follow-up time, the number of recurrences, and other clinical factors ( 31 - 33 ). In this study, we found significant differences in the follow-up time and the number of recurrences between the PPDM-A and non-PPDM-A groups in the training and internal validation cohorts.…”

Section: Discussionmentioning

confidence: 99%

A radiomics model of contrast-enhanced computed tomography for predicting post-acute pancreatitis diabetes mellitus

Hu,

Yang,

Zeng

et al. 2024

Quant Imaging Med Surg

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Background Diabetes mellitus can occur after acute pancreatitis (AP), but the accurate quantitative methods to predict post-acute pancreatitis diabetes mellitus (PPDM-A) are lacking. This retrospective study aimed to establish a radiomics model based on contrast-enhanced computed tomography (CECT) for predicting PPDM-A. Methods A total of 374 patients with first-episode AP were retrospectively enrolled from two tertiary referral centers. There were 224 patients in the training cohort, 56 in the internal validation cohort, and 94 in the external validation cohort, and there were 86, 22, and 27 patients with PPDM-A in these cohorts, respectively. The clinical characteristics were collected from the hospital information system. A total of 2,398 radiomics features, including shape-based features, first-order histogram features, high order textural features, and transformed features, were extracted from the arterial- and venous-phase CECT images. Intraclass correlation coefficients were used to assess the intraobserver reliability and interobserver agreement. Random forest-based recursive feature elimination, collinearity analysis, and least absolute shrinkage and selection operator (LASSO) were used for selecting the final features. Three classification methods [eXtreme Gradient Boosting (XGBoost), Adaptive Boosting, and Decision Tree] were used to build three models and performances of the three models were compared. Each of the three classification methods were used to establish the clinical model, radiomics model, and combined model for predicting PPDM-A, resulting in a total of nine classifiers. The predictive performances of the models were evaluated by the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F1-score. Results Eleven radiomics features were selected after a reproducibility test and dimensionality reduction. Among the three classification methods, the XGBoost classifier showed better and more consistent performances. The AUC of the XGBoost’s radiomics model to predict PPDM-A in the training, internal, and external cohorts was good (0.964, 0.901, and 0.857, respectively). The AUC of the XGBoost’s combined model to predict PPDM-A in the training, internal, and external cohorts was good (0.980, 0.901, and 0.882, respectively). The AUC of the XGBoost’s clinical model to predict PPDM-A in the training, internal, and external cohorts did not perform well (0.685, 0.733, and 0.619, respectively). In the external validation cohort, the AUC of the XGBoost’s radiomics model was significantly higher than that of the clinical model (0.857 vs. 0.619, P<0.001), but there was no significant difference between the combined and radiomics models (0.882 vs. 0.857, P=0.317). Conclusions The radiomics model based on CECT performs well and can be used as an earl...

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“…In patients with pancreatitis, the trypsin in the pancreas is activated, leading to edema and bleeding in the tissues around the pancreas, and even produce necrotic inflammatory reactions, which seriously reduces the life quality of patients[ 13 , 14 ]. In addition to clinical treatment, scientific nursing intervention is equally important, while the nursing intervention alone cannot achieve an ideal effect[ 15 , 16 ]. Therefore, on the basis of standardized nursing, more comprehensive and high-quality intervention measures should be taken.…”

Section: Discussionmentioning

confidence: 99%

Influence of standardized nursing intervention combined with mindfulness stress reduction training on the curative effect in patients with acute pancreatitis

Li,

Yin,

Guo

2023

World J Clin Cases

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BACKGROUND Acute pancreatitis (AP) is a common inflammatory disease of the pancreas with high mortality rates. It is of great significance to take scientific intervention measures for patients with AP in time. AIM To explore the effect of standardized nursing combined with mindfulness stress reduction training on the curative effect, negative emotion, and quality of life in patients with acute pancreatitis. METHODS A total of 80 patients with acute pancreatitis admitted to The First People's Hospital of Jiangxia District Hospital from May 2021 to May 2023 were randomly divided into control group and observation group (n = 40). Patients in control group were given the standardized nursing intervention, and the observation group were given standardized nursing plus mindfulness stress reduction training intervention. The time of clinical symptom disappeared or improved, complication occurrence rate, emotional state, and quality of life score of the two groups were observed and compared. RESULTS In comparison with the control group, the bowel sound recovery time, ventosity and abdominal pain improvement time, and venting and cacation time in observation group were shorter, and the total incidence rate of complications was reduced, showing statistically significant difference (P < 0.05). The scores of anxiety and depression in observation group were lower than those in control group (P < 0.05). Serum levels of tumour necrosis factor alpha, interleukin (IL)-6, IL-1β and IL-8 in observation group were lower than those in control group (P < 0.05). The scores of life quality in physiology, psychology, environment and social relations in observation group were higher than those in control group, and the differences were statistically significant (P < 0.05). CONCLUSION The application of standardized nursing intervention combined with mindfulness stress reduction training in patients with acute pancreatitis has a definite effect, which can help to ameliorate the clinical symptoms, anxiety and depression of patients, reduce the incidence rate of complications, and improve the prognosis of patients.

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Number of recurrences is significantly associated with the post-acute pancreatitis diabetes mellitus in a population with hypertriglyceridemic acute pancreatitis

Cited by 6 publications

References 35 publications

Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis

Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis

A radiomics model of contrast-enhanced computed tomography for predicting post-acute pancreatitis diabetes mellitus

Influence of standardized nursing intervention combined with mindfulness stress reduction training on the curative effect in patients with acute pancreatitis

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