Association of pancreatitis with risk of diabetes: analysis of real-world data

Djibril M. Ba, Vernon M. Chinchilli, Anna M. Cozzi, David P. Bradley, Ariana R. Pichardo-Lowden
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Abstract

Diabetes is a major cause of disease burden with considerable public health significance. While the pancreas plays a significant role in glucose homeostasis, the association between pancreatitis and new onset diabetes is not well understood. The purpose of this study was to examine that association using large real-world data.Utilizing the IBM® MarketScan® commercial claims database from 2016 to 2019, pancreatitis and diabetes regardless of diagnostic category, were identified using International Classification of Diseases, Tenth Revision [ICD-10] codes. We then performed descriptive analyses characterizing non-pancreatitis (NP), acute pancreatitis (AP), and chronic pancreatitis (CP) cohort subjects. Stratified Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) of diabetes across the three clinical categories.In total, 310,962 individuals were included in the analysis. During 503,274 person‐years of follow‐up, we identified 15,951 incident diabetes cases. While men and women had higher incidence rates of CP and AP-related diabetes, the rates were significantly greater in men and highest among individuals with CP (91.6 per 1000 persons-years (PY)) followed by AP (75.9 per 1000-PY) as compared to those with NP (27.8 per 1000-PY). After adjustment for diabetes risk factors, relative to the NP group, the HR for future diabetes was 2.59 (95% CI: 2.45-2.74) (P<0.001) for the CP group, and 2.39 (95% CI: 2.30-2.48) (P<0.001) for the AP group.Pancreatitis was associated with a high risk of diabetes independent of demographic, lifestyle, and comorbid conditions.
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胰腺炎与糖尿病风险的关系:真实世界数据分析
糖尿病是造成疾病负担的主要原因之一,对公众健康具有重大意义。虽然胰腺在葡萄糖稳态中发挥着重要作用,但胰腺炎与新发糖尿病之间的关联却不甚了解。本研究的目的是利用大型真实世界数据来研究这种关联。我们利用 2016 年至 2019 年的 IBM® MarketScan® 商业索赔数据库,使用《国际疾病分类》第十版 [ICD-10] 代码确定了胰腺炎和糖尿病(无论诊断类别)。然后,我们对非胰腺炎(NP)、急性胰腺炎(AP)和慢性胰腺炎(CP)队列受试者的特征进行了描述性分析。我们使用分层 Cox 比例危险回归模型来估计三个临床类别中糖尿病的危险比 (HR) 和 95% 置信区间 (CI)。在 503,274 人年的随访中,我们发现了 15,951 例糖尿病病例。虽然男性和女性的 CP 和 AP 相关糖尿病发病率都较高,但与 NP(27.8/1000-PY)相比,男性的发病率明显更高,CP 患者的发病率最高(91.6/1000 人-年),其次是 AP 患者(75.9/1000-PY)。经糖尿病风险因素调整后,相对于 NP 组,CP 组未来糖尿病的 HR 为 2.59(95% CI:2.45-2.74)(P<0.001),AP 组为 2.39(95% CI:2.30-2.48)(P<0.001)。
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