Impaired glucose tolerance in acute pancreatitis

Table 1 Mortality of acute pancreatitis in patients with pre-existing diabetes mellitus and those without diabetes mellitus

Ref.	Country	Diagnosis of DM	Prevalence of DM	Mortality of AP with DM	Mortality of AP without DM	Mortality of AP with DM compared to AP without DM
Graham et al[26], (2010)	United States	Two patients databases	Undescribed	Undescribed	Undescribed	Lower
Shen et al[27], (2012)	Taiwan	The Taiwan National Insurance Research Databese	Case-control study	3.5%	4.1%	Lower
Zhao et al[33], (2012)	China	History or HbA1c	12.6% (40/318)	15.0%	1.1%	Higher
Kikuta et al, (present study)	Japan	Questionnaire	12.8% (250/1954)	4.0%	1.7%	Higher

AP: Acute pancreatitis; DM: Diabetes mellitus.

Table 2 Characteristics of the study population n (%)

	Total AP patients	AP patients with DM	AP patients without DM	P value
Patients, n	1954	250	1704
Sex
Male	1289 (66.0)	185 (74.0)	1104 (64.8)	0.004
Female	665 (34.0)	65 (26.0)	600 (35.2)
Age, yr, mean ± SD	59.3 ± 18.0	60.3 ± 16.6	59.1 ± 18.2	0.319
Etiology
Alcoholic	621 (31.8)	97 (38.8)	524 (30.8)	0.107
Biliary	482 (24.7)	52 (20.8)	430 (25.2)
Idiopathic	319 (16.3)	34 (13.6)	285 (16.7)
Miscellaneous	482 (24.7)	60 (24.0)	422 (24.8)
Undescribed	50 (2.6)	7 (2.8)	43 (2.5)
BMI, mean ± SD	22.5 ± 4.0	23.5 ± 4.2	22.3 ± 4.0	< 0.001
Triglyceride, mg/dL,
median (1st, 3rd quartile)	97 (64, 170.5)	137 (79.5, 526)	94 (63, 157.75)	0.004

AP: Acute pancreatitis; DM: Diabetes mellitus.

Table 3 Prevalence of diabetes mellitus in patients with acute pancreatitis stratified by age

Age	General population (MHLW 2007)	All AP patients	Alcoholic AP	Biliary AP	Idiopathic AP
Total	10.5%	12.8%b	15.6%d	10.8%	10.7%
	(420/4003)	(250/1954)	(97/621)	(52/482)	(34/319)
< 19	Not available	5.3%	0%	No patients	16.7%
		(1/19)	(0/1)		(1/6)
20-29	0.5%	9.3%d	11.9%d	0%	3.4%
	(1/204)	(9/97)	(5/42)	(0/4)	(1/29)
30-39	1.4%	12.0%d	13.0%d	0%	13.8%c
	(8/589)	(25/208)	(15/115)	(0/18)	(4/29)
40-49	4.7%	12.8%d	12.8%d	14.3%a	16.7%a
	(26/557)	(34/265)	(21/164)	(4/28)	(4/24)
50-59	8.0%	12.2%a	13.9%a	7.8%	15.6%
	(57/711)	(41/336)	(21/151)	(5/64)	(5/32)
60-69	17.7%	14.8%	22.6%	13.0%	13.5%
	(165/934)	(50/338)	(19/84)	(13/100)	(7/52)
> 70	16.2%	13.3%	29.1%a	11.2%	8.5%a
	(163/1008)	(87/652)	(16/55)	(29/259)	(12/141)
Uncertain age	No patients	7.7%	0%	11.1%	0%
		(3/39)	(0/9)	(1/9)	(0/6)

The prevalence of DM in the Japanese general population in 2007 was cited from a report by the Ministry of Health, Labour and Welfare (http://www.mhlw.go.jp/bunya/kenkou/eiyou09/dl/01-kekka-01.pdf).

^aP < 0.05,

^bP < 0.01,

^cP < 0.005,

^dP < 0.001 vs the prevalence of DM in Japanese general population. AP: Acute pancreatitis; DM: Diabetes mellitus.

Table 4 Mortality of the acute pancreatitis patients stratified by age, etiology and diabetes mellitus

	AP patients with DM	AP patients without DM	P value
Total AP patients	4.0% (9/226)	1.7% (27/1587)	0.036
< 19	0% (0/1)	0% (0/17)	> 0.999
20-29	0% (0/8)	0% (0/82)	> 0.999
30-39	0% (0/25)	1.2% (2/173)	> 0.999
40-49	0% (0/34)	0.5% (1/217)	> 0.999
50-59	0% (0/41)	1.1% (3/277)	> 0.999
60-69	4.9% (2/41)	1.8% (5/271)	0.231
> 70	9.5% (7/74)	3.1% (16/516)	0.017
Uncertain age	0% (0/2)	0% (0/34)	> 0.999
Alcoholic AP	1.1% (1/92)	1.2% (6/489)	> 0.999
< 19	No patients	0% (0/1)	Not determined
20-29	0% (0/4)	0% (0/34)	> 0.999
30-39	0% (0/15)	1.1% (1/93)	> 0.999
40-49	0% (0/21)	0.7% (1/134)	> 0.999
50-59	0% (0/21)	0.8% (1/120)	> 0.999
60-69	0% (0/16)	4.9% (3/61)	> 0.999
> 70	6.7% (1/15)	0% (0/38)	0.283
Uncertain age	No patients	0% (0/8)	Not determined
Biliary AP	2.3% (1/44)	1.0% (4/409)	0.402
< 19	No patients	No patients	Not determined
20-29	No patients	0% (0/4)	Not determined
30-39	No patients	0% (0/17)	Not determined
40-49	0% (0/4)	0% (0/23)	> 0.999
50-59	0% (0/5)	1.8% (1/57)	> 0.999
60-69	0% (0/11)	0% (0/86)	> 0.999
> 70	4.3% (1/23)	1.4% (3/214)	0.337
Uncertain age	0% (0/1)	0% (0/8)	> 0.999
Idiopathic AP	9.7% (3/31)	2.7% (7/261)	0.078
< 19	0% (0/1)	0% (0/4)	> 0.999
20-29	0% (0/1)	0% (0/26)	> 0.999
30-39	0% (0/4)	0% (0/24)	> 0.999
40-49	0% (0/4)	0% (0/20)	> 0.999
50-59	0% (0/5)	0% (0/27)	> 0.999
60-69	16.7% (1/6)	2.6% (1/39)	0.252
> 70	20.0% (2/10)	5.2% (6/115)	0.125
Uncertain age	No patients	0% (0/6)	Not determined

AP: Acute pancreatitis; DM: Diabetes mellitus.

Table 5 Multivariate analyses of risk factors of mortality

Variable	Univariate			Multivariate
	OR	95%CI	P value	Adjusted OR	95%CI	P value
Age (yr)	1.05	1.02-1.07	< 0.001	1.05	1.02-1.07	< 0.001
DM (present/absent)	2.40	1.05-4.97	0.038	2.50	1.09-5.24	0.032
BMI (kg/m2)	0.98	0.88-1.08	0.672
TG (mg/dL)	1.00	0.98-1.00	0.712

BMI: Body mass index; CI: Confidence interval; OR: Odds ratio; TG: Triglyceride.