Visceral Fat Predicts New-Onset Diabetes After Necrotizing Pancreatitis.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-03-01 Epub Date: 2024-01-25 DOI:10.1097/MPA.0000000000002292

Guru Trikudanathan, Mohamed Abdallah, Satish Munigala, Kornpong Vantanasiri, David Jonason, Nauroze Faizi, Robben Schat, Anil Chauhan, Martin L Freeman, Melena D Bellin

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Abstract

Objectives: We aimed to estimate the incidence of new-onset diabetes (NOD) and identify risk factors for NOD in patients with necrotizing pancreatitis (NP).

Methods: Necrotizing pancreatitis patients were reviewed for NOD, diagnosed >90 days after acute pancreatitis. Baseline demographics, comorbidities, clinical outcomes, computed tomography (CT) characteristics of necrotic collections, and CT-derived abdominal fat measurements were analyzed to identify predictors for NOD.

Results: Among 390 eligible NP patients (66% men; median age, 51 years; interquartile range [IQR], 36-64) with a median follow-up of 400 days (IQR, 105-1074 days), NOD developed in 101 patients (26%) after a median of 216 days (IQR, 92-749 days) from NP. Of the NOD patients, 84% required insulin and 69% developed exocrine pancreatic insufficiency (EPI). Age (odds ratio [OR], 0.98), male sex (OR, 2.7), obesity (OR, 2.1), presence of EPI (OR, 2.7), and diffuse pancreatic necrosis (OR, 2.4) were independent predictors. In a separate multivariable model assessing abdominal fat on CT, visceral fat area (highest quartile) was an independent predictor for NOD (OR, 3.01).

Conclusions: New-onset diabetes was observed in 1 of 4 patients with NP, most within the first year and requiring insulin. Male sex, obesity, diffuse pancreatic necrosis, development of EPI, and high visceral adiposity identified those at highest risk.

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内脏脂肪可预测坏死性胰腺炎后新发的糖尿病

目的我们旨在估算坏死性胰腺炎（NP）患者中新发糖尿病（NOD）的发病率，并确定NOD的风险因素：方法：对急性胰腺炎后90天以上诊断为NOD的坏死性胰腺炎患者进行复查。分析了基线人口统计学、合并症、临床结果、坏死组织的计算机断层扫描（CT）特征以及 CT 导出的腹部脂肪测量值，以确定 NOD 的预测因素：在 390 名符合条件的 NP 患者中（66% 为男性；中位年龄 51 岁；四分位数间距 [IQR]，36-64），中位随访时间为 400 天（IQR，105-1074 天），101 名患者（26%）在 NP 中位 216 天（IQR，92-749 天）后出现 NOD。在 NOD 患者中，84% 需要胰岛素，69% 出现胰腺外分泌功能不全 (EPI)。年龄（比值比 [OR]，0.98）、男性（OR，2.7）、肥胖（OR，2.1）、EPI（OR，2.7）和弥漫性胰腺坏死（OR，2.4）是独立的预测因素。在一个评估CT显示的腹部脂肪的单独多变量模型中，内脏脂肪面积（最高四分位数）是新发糖尿病的独立预测因素（OR，3.01）：结论：每 4 名 NP 患者中就有 1 人出现新发糖尿病，大多数患者在第一年内发病，需要使用胰岛素。男性、肥胖、弥漫性胰腺坏死、EPI的发展以及高内脏脂肪率确定了高危人群。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.