Acute Pancreatitis in Youth Linked to Diabetes Risk: Study Identifies Key Predictors
USA: A study published in Digestive and Liver Disease suggests that youths who experience acute pancreatitis may face an increased risk of developing prediabetes or diabetes. Key factors associated with this risk include the severity of the condition, levels of C-reactive protein and interleukin-6, and subcutaneous fat area.
"Within three months, 15.3% of participants developed prediabetes, and 0.7% developed diabetes. At the one-year mark, these rates were 12.5% and 3.5%, respectively," the researchers reported.
Acute pancreatitis (AP) has been linked to an elevated risk of diabetes mellitus (DM). Maisam Abu-El-Haija, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA, and colleagues aimed to identify clinical, laboratory, and imaging predictors of prediabetes (preDM) and DM in youth following an initial episode of AP.
For this purpose, the researchers conducted a prospective cohort study involving patients aged ≤21 with an initial admission for acute pancreatitis, followed by evaluations at 3 and/or 12 months. Clinical laboratory values, imaging findings, admission course details, and plasma chemokine and cytokine levels collected during the index admission were analyzed for their association with the development of prediabetes or diabetes mellitus. A multivariable regression model was employed to identify predictors of preDM/DM.
The study led to the following findings:
- Of the 187 enrolled participants, 137 (73%) underwent diabetes screening at 3 months, 144 (77%) at 12 months, and 137 (73%) had imaging data available.
- At 3 months, 16% developed prediabetes/diabetes (preDM: 21; DM: 1).
- At 12 months, 16% developed prediabetes/diabetes (preDM: 18; DM: 5).
- Univariate associations with preDM/DM at 12 months included:
- Severe acute pancreatitis (SAP): 52% in the preDM/DM group vs. 17% in the no DM group.
- Median IL-6 levels: 910 pg/ml in the preDM/DM group vs. 196 pg/ml in the DM group.
- Median CRP levels: 4.16 mg/L [IQR 1.67–10.7] in the preDM/DM group vs. 1.55 mg/L in the no DM group.
- The optimal multivariable model using clinical variables to predict preDM/DM included severe acute pancreatitis (SAP), C-reactive protein (CRP), interleukin-6 (IL-6), and age [AUC = 0.80].
- When imaging markers were included, the ideal model incorporated SAP, CRP, IL-6, subcutaneous fat area, age, and autoimmune disease presence [AUC = 0.82].
The authors noted that their predictive model could be valuable during the initial acute pancreatitis episode, as this is believed to be the point when the underlying injury leading to prediabetes or diabetes begins. "Utilizing this model may assist in planning follow-up care and identifying specific patients at higher risk for developing prediabetes or diabetes, enabling targeted future testing," the researchers concluded.
Reference:
Ginzburg, G., Debnath, P., Zhang, Y., Ata, N. A., Farrell, P. R., Garlapally, V., Kotha, N., Thompson, T., Vitale, D. S., Trout, A. T., & Abu-El-Haija, M. (2024). Clinical and imaging predictors for the development of diabetes mellitus following a single episode of acute pancreatitis in youth. Digestive and Liver Disease. https://doi.org/10.1016/j.dld.2024.10.009
