title: Dipeptidyl Peptidase-4 Inhibitors and the Risk of Acute Pancreatitis in Patients With Type 2 Diabetes in Taiwan: A Population-Based Cohort Study.
abstract: To investigate the effects of dipeptidyl peptidase-4 (DPP-4) inhibitors on the risk of acute pancreatitis in patients with type 2 diabetes.This nationwide population-based cohort study used the diabetes patients dataset of Taiwan's National Health Research Insurance Research Database. Patients with newly diagnosed type 2 diabetes between January 1, 2008 and December 31, 2009 and no history of acute pancreatitis were selected. This cohort was followed from the index date to the onset of acute pancreatitis or December 31, 2011. The main outcome measure was the hazard ratio (HR) for acute pancreatitis associated with DPP-4 inhibitor use. Cox proportional-hazards regression analyses were adjusted for alcohol use, hypertriglyceridemia, cholelithiasis, neoplasm, and Diabetes Complications Severity Index (DCSI) score. Subgroup analyses stratified by age and sex were conducted.The study cohort comprised 114,141 patients. Significant interaction effects were observed between sex and age (HR 0.80, 95% confidence interval [CI] 0.64-0.99) and age and DCSI score (HR 0.83, 95% CI: 0.71-0.97). In subgroup analyses, significant risks of acute pancreatitis were noted in female and elderly DPP-4 inhibitor users. Among women, the risk of acute pancreatitis was significantly higher among DPP-4 inhibitor users than among nonusers (HR 2.27, 95% CI: 1.30-3.97). This risk was also significantly higher in users than in nonusers among patients aged >65 years (HR 2.39, 95% CI: 1.11-5.15).Female and elderly DPP-4 inhibitor users had significantly elevated risks of acute pancreatitis development. Further well-conducted studies are needed to confirm our findings.
authors.affiliation: From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou (YJL); Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei (YJL, HYH, HHC, PC); School of Medicine, National Yang-Ming University, Taipei (YJL, HHC); Department of Exercise Health Science, National Taiwan University of Sport (YJL); Department of Education and Research, Taipei City Hospital, Taipei (HYH); Department of Medical Research, Taichung Veterans General Hospital (HHC); Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University (HHC); Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital (HHC); School of Medicine, Chung-Shan Medical University (HHC); and Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan, ROC (HHC).
authors.forename: Yun-Ju
authors.initials: YJ
authors.lastname: Lai
authors.forename: Hsiao-Yun
authors.initials: HY
authors.lastname: Hu
authors.forename: Hsin-Hua
authors.initials: HH
authors.lastname: Chen
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000139:chemically induced*; D018570:Risk Assessment; D013624:Taiwan; D055815:Young Adult
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors