title: Occurrence of and risk factors for diabetes mellitus in Chinese patients with chronic pancreatitis.
abstract: OBJECTIVE
  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.
authors.affiliation: Chronic Pancreatitis Study Group, Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Guo
authors.forename: Zhuan
authors.initials: Z
authors.lastname: Liao
authors.forename: Duo-Wu
authors.initials: DW
authors.lastname: Zou
authors.forename: Zhen-Dong
authors.initials: ZD
authors.lastname: Jin
authors.forename: Da-Jin
authors.initials: DJ
authors.lastname: Zou
authors.forename: Gang
authors.initials: G
authors.lastname: Jin
authors.forename: Xian-Gui
authors.initials: XG
authors.lastname: Hu
authors.forename: Zhao-Shen
authors.initials: ZS
authors.lastname: Li
mesh_terms: D000328:Adult; D017668:Age of Onset; D044466:Asian People / Q000706:statistics & numerical data*; D002114:Calcinosis / Q000208:ethnology; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000208:ethnology*; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000208:ethnology; D010180:Pancreatectomy / Q000009:adverse effects; D050500:Pancreatitis, Chronic / Q000208:ethnology* / Q000601:surgery; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000208:ethnology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult