Dataset Information

Effect of acute pancreatitis on the risk of developing osteoporosis: A nationwide cohort study.

ABSTRACT:

Purpose

Chronic exocrine pancreatic insufficiency can lead to osteoporosis. However, the incidence and risk of osteoporosis after acute inflammation of pancreas remained known. Thus, we conducted a population-based cohort study to clarify the association between acute pancreatitis (AP) and osteoporosis.

Methods

Patients newly diagnosed with AP with index date between 2000 and 2011 were identified from the National Health Insurance Research Database. Osteoporosis were defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. We applied age-, sex-, and comorbidities-adjusted variable Cox proportional hazard models for assessing the association between AP and osteoporosis. Moreover, these models were used to adjust for the influences of patient characteristics and comorbidities.

Results

In this study, 4,016 patients were included in the AP cohort (males, 67.9%; mean age, 51.8 years) and 4,016 matched controls in the non-AP cohort. After a mean follow-up period of 4.97 and 5.21 years in the AP and non-AP cohorts, respectively, the incidence of osteoporosis was 8.22 per 1000 person-years in the AP cohort. The AP cohort had a higher risk [adjusted hazard ratio (aHR) = 1.27, 95% confidence interval (CI) = 1.02-1.58] of osteoporosis than did the non-AP cohort. The risk of osteoporosis was highest in the female patients of the AP cohort (aHR = 2.26, 95% CI = 1.85-2.76) and patients aged 50-64 years (aHR = 4.14, 95% CI = 3.13-5.47).

Conclusion

AP patients are at a risk of osteoporosis, especially female gender and age 50-64 years. Those with > 3 episodes of AP had highest significant risk of developing osteoporosis.

SUBMITTER: Lin SY

PROVIDER: S-EPMC5467899 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Effect of acute pancreatitis on the risk of developing osteoporosis: A nationwide cohort study.

Lin Shih-Yi SY Hsu Wu-Huei WH Lin Cheng-Chieh CC Lin Cheng-Li CL Tsai Chung-Hao CH Kao Chia-Hung CH

PloS one 20170612 6

<h4>Purpose</h4>Chronic exocrine pancreatic insufficiency can lead to osteoporosis. However, the incidence and risk of osteoporosis after acute inflammation of pancreas remained known. Thus, we conducted a population-based cohort study to clarify the association between acute pancreatitis (AP) and osteoporosis.<h4>Methods</h4>Patients newly diagnosed with AP with index date between 2000 and 2011 were identified from the National Health Insurance Research Database. Osteoporosis were defined accor ...[more]

PMID: 28604838

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Project description:To explore the risk factors of developing chronic pancreatitis (CP) in patients with acute pancreatitis (AP) and develop a prediction score for CP. Using the National Health Insurance Research Database in Taiwan, we obtained large, population-based data of 5971 eligible patients diagnosed with AP from 2000 to 2013. After excluding patients with obstructive pancreatitis and biliary pancreatitis and those with a follow-up period of less than 1 year, we conducted a multivariate analysis using the data of 3739 patients to identify the risk factors of CP and subsequently develop a scoring system that could predict the development of CP in patients with AP. In addition, we validated the scoring system using a validation cohort. Among the study subjects, 142 patients (12.98%) developed CP among patients with RAP. On the other hand, only 32 patients (1.21%) developed CP among patients with only one episode of AP. The multivariate analysis revealed that the presence of recurrent AP (RAP), alcoholism, smoking habit, and age of onset of < 55 years were the four important risk factors for CP. We developed a scoring system (risk score 1 and risk score 2) from the derivation cohort by classifying the patients into low-risk, moderate-risk, and high-risk categories based on similar magnitudes of hazard and validated the performance using another validation cohort. Using the prediction score model, the area under the curve (AUC) [95% confidence interval (CI)] in predicting the 5-year CP incidence in risk score 1 (without the number of AP episodes) was 0.83 (0.79, 0.87), whereas the AUC (95%CI) in risk score 2 (including the number of AP episodes) was 0.84 (0.80, 0.88). This result demonstrated that the risk score 2 has somewhat better prediction performance than risk score 1. However, both of them had similar performance between the derivation and validation cohorts. In the study,we identified the risk factors of CP and developed a prediction score model for CP.

Project description:Simple Summary The effect of acute pancreatitis on diabetic patients in terms of the occurrence of malignant tumors is not well understood. The main contribution of this study is to investigate the association between acute pancreatitis and gastrointestinal cancer in type 2 diabetic patients. Diabetic patients who had a history of acute pancreatitis showed a higher incidence of all gastrointestinal cancers, not only pancreatic cancer. The risk of gastrointestinal cancer in diabetic patients was increased by 1.6 to 4.5 times depending on the history of acute pancreatitis. It seems necessary to investigate the history of acute pancreatitis in diabetic patients and more actively recommend screening for gastrointestinal cancers in such patients. Results of this study suggest that proper management or prevention of acute pancreatitis might be important for diabetic patients. Abstract The association between acute pancreatitis (AP) and gastrointestinal cancers in diabetic patients is currently not well understood. The study aim was to investigate the association between AP and gastrointestinal cancers in diabetic patients. Data from the Korean National Health Insurance Service database were analyzed. Participants with diabetes who underwent a health examination between 2009 and 2012 were followed up till December 2018. The primary outcome was the occurrence of gastrointestinal cancer. A total of 2,263,184 patients were included in the final analysis. Patients with a history of AP (n = 2390) were found to have a significantly higher risk of gastrointestinal cancer, except for esophageal cancer, as follows: gastric cancer (aHR = 1.637, 95% CI: 1.323–2.025), colorectal cancer (aHR = 2.183, 95% CI: 1.899–2.51), liver cancer (aHR = 2.216, 95% CI: 1.874–2.621), pancreatic cancer (aHR = 4.558, 95% CI: 4.078–5.095), bile duct cancer (aHR = 3.996, 95% CI: 3.091–5.269), and gallbladder cancer (aHR = 2.445, 95% CI: 1.459–4.099). The history of AP is associated with the increased risk of gastrointestinal cancer in diabetic patients. It is necessary to investigate the history of AP and more actively recommend screening for gastrointestinal cancers in such patients.

Dataset Information

Effect of acute pancreatitis on the risk of developing osteoporosis: A nationwide cohort study.

Purpose

Methods

Results

Conclusion

Publications

Effect of acute pancreatitis on the risk of developing osteoporosis: A nationwide cohort study.

Similar Datasets

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