首页|Diabetes mellitus in patients with type 1 autoimmune pancreatitis at diagnosis and after corticosteroid therapy

Diabetes mellitus in patients with type 1 autoimmune pancreatitis at diagnosis and after corticosteroid therapy

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  • 国家科技期刊平台
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  • NSTL
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Background:A high prevalence of diabetes mellitus(DM)coexisting with autoimmune pancreatitis(AIP)is observed.However,evidence on the circumstances under which corticosteroid therapy(CST)for AIP improves or worsens DM is scarce.This study aimed to demonstrate and identify predictors of DM control under the influence of CST.Methods:Patients diagnosed with type 1 AIP were enrolled from a prospectively maintained cohort and were classified into three groups according to the chronology in which AIP and DM were diagnosed:pre-existing DM(pDM),concurrent DM(cDM),and non-DM(nDM).The responses of DM to CST were assessed when corticosteroid was ceased or tapered to a maintenance dose and classified as'improve-ment'and'non-improvement'(including'no change'and'exacerbation').Results:Among 101 patients with type 1 AIP,52(51.5％)patients were complicated with DM at the time of AIP diagnosis,with 36 patients in the cDM group and 16 patients in the pDM group.The incidences of diffuse pancreatic swelling(72.2％)and pancreatic body/tail involvement(91.7％)were significantly higher in the cDM group than in both the pDM and nDM groups.Of the 52 patients with DM,CST was adminis-tered in 48 cases.Multivariate logistic analysis identified that elevated serum gamma-glutamyl transferase(GGT)level at AIP diagnosis[odds ratio(OR)=0.032,95％confidence interval(CI):0.003-0.412,P=0.008]and pancreatic atrophy after CST(OR=0.027,95％CI:0.003-0.295,P=0.003)were negatively associated with DM control improvement.Conclusions:Patients with diffuse pancreatic swelling and pancreatic body/tail involvement in pancreati-tis tended to be complicated with cDM at AIP diagnosis.CST exerted a beneficial effect on the clinical course of DM in nearly half of the AIP patients complicated with DM at diagnosis,particularly in those without elevated serum GGT levels at diagnosis and who did not experience pancreatic atrophy after CST.

Type 1 autoimmune pancreatitisDiabetes mellitusCorticosteroid therapyPredictive factorPancreatic atrophy

Mei-Zi Li、Tao Guo、Yun-Lu Feng、Sheng-Yu Zhang、Xiao-Yin Bai、Xi Wu、Kai Xu、Ai-Ming Yang

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Department of Gastroenterology,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100730,China

Department of Radiology,Peking Union Medical College Hospital,Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100730,China

CAMS Innovation Fund for Medical Sciences(CIFMS)National Key Clinical Specialty Construction ProjectNational High-Level Hospital Clinical Research FundingNational Natural Science Foundation of China,Joint Fund Project

2021-I2M-1-002ZK1080002022-PUMCH-B-024U20A600

2024

10.1016/j.hbpd.2023.04.006

国际肝胆胰疾病杂志(英文版)
浙江省医学学术交流管理中心,浙江大学医学院附属第一医院,浙江大学出版社有限责任公司

国际肝胆胰疾病杂志(英文版)

影响因子：0.668
ISSN：1499-3872
年,卷(期)：2024.23(4)
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