Occurrence of and Risk Factors for Diabetes Mellitus in Chinese Patients With Chronic Pancreatitis
Occurrence of and Risk Factors for Diabetes Mellitus in Chinese Patients With Chronic Pancreatitis
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DOI：
10.1097/mpa.0b013e31820032ae
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发表时间：
2011-03
期刊：
影响因子：
2.9
通讯作者：
Wei Wang;Yan Guo;Z. Liao;D. Zou;Zhendong Jin;D. Zou;G. Jin;Xian-gui Hu;Zhao-Shen Li
中科院分区：
文献类型：
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作者：
Wei Wang;Yan Guo;Z. Liao;D. Zou;Zhendong Jin;D. Zou;G. Jin;Xian-gui Hu;Zhao-Shen Li
目的：本研究的目的是确定中国慢性胰腺炎（CP）患者中糖尿病（DM）的发生率和危险因素，特别是那些接受内镜或手术治疗的CP患者。方法：对1997年1月1日至2007年7月31日在我院就诊的445例接触过CP的患者进行随访。排除58例患者后，在多变量分析中确定糖尿病的危险因素。结果如下：CP发病后20年的DM累积发生率为51.5%（SD，8%），内镜治疗或手术后10年的DM累积发生率为27.8%（SD，6%），两种治疗之间无显著差异（P = 0.243）。CP发病年龄（风险比，1.032; 95%可信区间，1.012-1.052），吸烟（2.859，1.448-5.645），慢性疼痛（0.412，0.180-0.945）和胰腺钙化（2.326，1.203-4.496）是糖尿病患者在任何侵入性治疗前发生糖尿病的独立危险因素。吸烟（2.203，1.153-4.209）和胰体尾切除术（5.412，2.506-11.690）是侵袭性治疗后患者发生DM的独立危险因素。结论：糖尿病的风险似乎主要是由CP的进展引起的，因为它随着年龄的增长而增加，没有慢性疼痛和胰腺钙化，而这种风险受到吸烟和远端胰腺切除术的影响。
Objectives: The aim of the study was to determine the occurrence and the risk factors of diabetes mellitus (DM) in Chinese patients with chronic pancreatitis (CP), with particular emphasis on those with endoscopic or surgical therapy for CP. Methods: Four hundred forty-five contacted CP patients in our hospital between January 1, 1997, and July 31, 2007, were followed up. Risk factors for DM were determined in a multivariate analysis after exclusion of 58 patients. Results: The cumulative rate of DM was 51.5% (SD, 8%) at 20 years after the onset of CP and 27.8% (SD, 6%) at 10 years after endotherapy or surgery, without significant difference between the 2 therapies (P = 0.243). The age at the onset of CP (hazard ratio, 1.032; 95% confidential interval, 1.012-1.052), smoking (2.859, 1.448-5.645), chronic pain (0.412, 0.180-0.945), and pancreatic calcifications (2.326, 1.203-4.496) were identified as independent risk factors for developing DM in the patients before any invasive therapy. Smoking (2.203, 1.153-4.209) and distal pancreatectomy (5.412, 2.506-11.690) were the independent risk factors for DM development in patients after invasive therapy. Conclusions: The risk of DM seems to be mainly caused by progression of CP because it increased with older age, absence of chronic pain, and pancreatic calcifications, whereas this risk is influenced by smoking and distal pancreatectomy.