| A comparative study of the clinical features and outcomes between acute pancreatitis with and without diabetes. | |
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MedLine Citation:
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PMID: 21988175 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Objective: To investigate the prevalence of diabetes in acute pancreatitis (AP), and to compare the clinical features of acute pancreatitis in patients with and without diabetes. Design, patients and measurements: We retrospectively collected 318 patients with acute pancreatitis in two clinical centers from January 2009 to October 2010. Patient with a previous history of diabetes or with glycosylated hemoglobin A1c (HbA1c) higher than 6.5% were identified as acute pancreatitis with diabetes (APD), while patients without history of diabetes and in whom the HbA1c was not higher than 6.5% were considered as AP only. The clinical characteristics and prognosis data of these patients were analyzed. Survival curves were plotted according to the Kaplan-Meier method. Cox proportional hazard regression was used to test the association between the clinical prognostic factors and mortality in acute pancreatitis patients. Results: In total, 318 patients with acute pancreatitis were enrolled. Among them, 40 were APD and 278 were AP; thus the prevalence of diabetes in acute pancreatitis was 12.6% (40/318). Twenty five percent (10/40) of the diabetic cases were indentified using HbA1c. The mortality rate was significantly higher in the APD group (15.0%, 6/40) than that in the AP group (1.1%, 3/278). Survival curves showed there was a significant survival difference between the APD group and AP group via the log-rank test. Multivariate Cox regression analysis showed that sex, age, diastolic blood pressure, body mass index (BMI) and C-peptide were significantly associated with mortality. Compared with AP patients, subjects with APD had significantly longer time from initial symptoms to admission [1.6 (95% CI: 0.5-3.2) vs. 0.9 (95% CI: 0.1-2.2) d], older age of onset (57.2 ± 11.0 vs. 44.3 ± 7.8 yrs), higher levels of glucose (13.9 ± 8.2 vs. 7.3 ± 4.1 mM), higher levels of HbA1c [8.5 (95% CI: 6.6-11.4)% vs. 5.9 (95% CI: 4.9-6.4)%)], lower levels of C-peptide (0.882 ± 0.337 vs. 2.621 ± 0.526 ng/mL) and longer duration of hospitalization (18.3 ± 4.6 vs. 13.2 ± 5.1 d). Electrocardiograms showed that APD patients had a significantly higher risk of heart ischaemia than AP patients (22/40 vs. 20/278). Conclusions: HbA1c may be a useful parameter to identify the unknown diabetes. Physicians should be alert to acute pancreatitis with diabetes since the APD group had poorer outcome than the AP group. |
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Authors:
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Xiaolong Zhao; Changmei Huangpu; Lili Chen; Lin Jiang; Min He; Jian Chen; Zhupeng Hu; Hongying Ye; Hong Hu; Linuo Zhou; Yiming Li; Renming Hu |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-10-11 |
Journal Detail:
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Title: Clinical endocrinology Volume: - ISSN: 1365-2265 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0346653 Medline TA: Clin Endocrinol (Oxf) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Blackwell Publishing Ltd. |
Affiliation:
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Department of Endocrinology and Metabolism, Huashan Hospital of Fudan University, Shanghai, China Intensive Care Unit, First Affiliated Hospital of Guangdong Medical College, Guangdong, China Emergency Department, Huashan Hospital of Fudan University, Shanghai, China Department of Gastroenterology, Huashan Hospital of Fudan University, Shanghai, China. |
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