Meta-analysis of the prevalence and risk factors of new diabetes after chronic pancreatitis / 中华胰腺病杂志

ABSTRACT

Objective:To evaluate the prevalence and related risk factors of new onset diabetes after chronic pancreatitis by meta-analysis.Methods:Chronic pancreatitis, diabetes, post pancreatitis diabetes, type 2 diabetes, type 3c diabetes, endocrine dysfunction, chronic pancreatitis, diabetes mellitus, post pancreatitis diabetes mellitus, endocrine efficiency, risk factors were used as keywords, and the network database such as the CNKI database, Wanfang, Weipu, Chinese Medical Journal Full Text, PubMed, Embase, Cochrane Library, Web of Science, and so on from the database establishment to January 2023 were searched. The prospective and retrospective cohort studies on new diabetes after chronic pancreatitis published were searched and retrieved, and the papers were screened and the quality were evaluated according to preset inclusion and exclusion criteria; and the important data were extracted. Review Manager 5.4 was used for meta-analysis.Results:22 papers were finally included, including 13 785 patients with chronic pancreatitis, of which 4 233 were patients with new onset diabetes. Meta-analysis showed that the incidence of new diabetes after chronic pancreatitis was 29% ( RD=0.29, 95% CI 26%-32%, P<0.0001), which increased and tended to be stable along with the disease course. Alcohol drinking, smoking, alcoholic chronic pancreatitis, pancreatic calcification, biliary stricture, male, conservative treatment, pancreatic cyst and older onset age were considered as risk factors for new diabetes after chronic pancreatitis, and endoscopic treatment was considered as protective factors. Conclusions:The incidence of new diabetes after the diagnosis of chronic pancreatitis is relatively high. Clinically, we can identify high-risk groups exposed to risk factors, and early intervention can reduce the incidence rate of new diabetes after chronic pancreatitis and improve the prognosis of patients.