title: Change of Both Endocrine and Exocrine Insufficiencies After Acute Pancreatitis in Non-Diabetic Patients: A Nationwide Population-Based Study.
abstract: Acute pancreatitis (AP) is the most common pancreatic disease and consists of an acute inflammation of the pancreas. AP can contribute to endocrine and exocrine insufficiencies in survivors as a result of the key role of the pancreas in both glucose metabolism and nutritional digestion. The aim of this population-based study was to determine the endocrine or exocrine insufficiencies in patients after initial AP with biliary or alcohol-associated causes.We conducted a nationwide cohort study using data from Taiwan's National Health Insurance Research Database collected between 2001 and 2010. A total of 12,284 patients with AP were identified.Alcohol-associated AP (odds ratio, 1.894; 95% CI, 1.520-2.268; P < 0.001) and ≥2 admissions for AP (odds ratio, 1.937; 95% CI, 1.483-2.391; P < 0.001) were significantly associated with newly diagnosed diabetes mellitus after AP. Further, only alcohol-associated AP (odds ratio, 1.215; 95% CI, 1.133-1.297; P < 0.001) was significantly associated with pancreatic exocrine insufficiency after AP. Additionally, alcohol-associated AP (odds ratio, 1.804; 95% CI, 1.345-2.263; P < 0.001) and ≥2 readmissions for AP (odds ratio, 3.190; 95% CI, 2.317-4.063; P < 0.001) were significantly associated with both exocrine and endocrine insufficiencies after AP.Our data showed that alcohol-associated AP, rather than a biliary cause, contributed to a higher extent to exocrine or endocrine insufficiencies. Furthermore, recurrent AP also led to endocrine insufficiency.
authors.affiliation: From the Department of Surgery (J-MW, T-CK, C-YY, H-SL, Y-WT); Department of Nursing, National Taiwan University Hospital and National Taiwan University College of Medicine (S-HH); and Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan, ROC (T-WH, J-MW, FL).
authors.forename: Te-Wei
authors.initials: TW
authors.lastname: Ho
authors.forename: Jin-Ming
authors.initials: JM
authors.lastname: Wu
authors.forename: Ting-Chun
authors.initials: TC
authors.lastname: Kuo
authors.forename: Ching-Yao
authors.initials: CY
authors.lastname: Yang
authors.forename: Hong-Shiee
authors.initials: HS
authors.lastname: Lai
authors.forename: Su-Hua
authors.initials: SH
authors.lastname: Hsieh
authors.forename: Feipei
authors.initials: F
authors.lastname: Lai
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Tien
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000209:etiology*; D010188:Exocrine Pancreatic Insufficiency / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications* / Q000503:physiopathology*; D019512:Pancreatitis, Alcoholic / Q000150:complications / Q000503:physiopathology; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors