Increased risk of acute pancreatitis in patients with type 2 diabetes: an observational study using a Japanese hospital database

Hisashi Urushihara, Masanori Taketsuna, Ying Liu, Eisei Oda, Masaki Nakamura, Shinichi Nishiuma, Rei Maeda, Hisashi Urushihara, Masanori Taketsuna, Ying Liu, Eisei Oda, Masaki Nakamura, Shinichi Nishiuma, Rei Maeda

Abstract

Background: 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.

Methods/findings: We 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).

Conclusions: This 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.

Conflict of interest statement

Competing Interests: HU has served as a consultant to Eli Lilly Japan and received a research grant from Pfizer Health Research Foundation. MT, YL, SN, and RM are full-time employees of Eli Lilly Japan. EO is the President of Medical TOUKEI Corporation. MN is a full-time employee of Medical Data Vision Co., Ltd. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1. Patient selection criteria for cohort…
Figure 1. Patient selection criteria for cohort substudy of the risk of acute pancreatitis associated with type 2 diabetes mellitus.
DM, diabetes mellitus; ICD10, International Statistical Classification of Diseases and Related Health Problems 10th Revision Version for 2003.

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