Abstract
BackgroundIncreased risks of acute pancreatitis in patients with type 2 diabetes mellitus have been reported recently in several countries. We aimed to estimate the risks of acute pancreatitis in Japanese patients with diabetes mellitus.Methods/FindingsWe examined a large-scale hospital administrative database consisting of one million patients in 16 secondary medical care hospitals, from 2003 to 2010. The incidence rates of acute pancreatitis were estimated with cohort design; the odds ratios associated with diabetes mellitus and other comorbid risk factors were estimated with separate case-control analyses.In cohort analysis, the incidence of acute pancreatitis was higher in 14,707 diabetic patients than in 186,032 non-diabetic patients (4.75 vs. 1.65 per 1,000 patient-years) and increased in male patients and as age advanced. The adjusted odds ratio of acute pancreatitis in patients with diabetes mellitus was 1.86 (P<0.001) compared with non-diabetic patients in case-control analysis from 1,372 cases and 5,469 matched controls, which is consistent with the ones reported in previous studies. Alcoholism and gallstones were associated with a large increase in the risk of acute pancreatitis (adjusted odds ratio 13.40 and 14.29, respectively, P<0.001), although dyslipidemia was associated with significant risk reduction (adjusted odds ratio 0.62, P<0.001).ConclusionsThis observational study ascertained the elevated incidence rates and risk of acute pancreatitis in Japanese patients with diabetes. The risk estimates in Japanese patients with diabetes were in agreement with the ones reported in previous studies, and the elevated risk of acute pancreatitis in patients with diabetes would be generalized in different locations/populations.
Highlights
Acute pancreatitis (AP) is becoming increasingly prevalent in Japan as well as in Western countries [1,2,3,4]
The risk estimates in Japanese patients with diabetes were in agreement with the ones reported in previous studies, and the elevated risk of acute pancreatitis in patients with diabetes would be generalized in different locations/populations
The first observational study using a US healthcare claim database reported that patients with type 2 diabetes mellitus (DM) had an increased risk of AP compared with the non-DM population in 2009 [9]
Summary
Acute pancreatitis (AP) is becoming increasingly prevalent in Japan as well as in Western countries [1,2,3,4]. A variety of risk factors for AP have been established, including alcoholic consumption, gallstones, obesity, hypertriglyceridemia, viral hepatitis, chronic pancreatitis, as well as some medications and other risk factors [6,7]. Some of these are common complications and risk factors for type 2 diabetes mellitus (DM).The association of AP with type 2 DM was first suggested by a randomized controlled trial of fenofibrate in patients with type 2 DM [8]. Increased risks of acute pancreatitis in patients with type 2 diabetes mellitus have been reported recently in several countries. We aimed to estimate the risks of acute pancreatitis in Japanese patients with diabetes mellitus
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