Risk of cardiovascular disease and mortality in patients with diabetes and acute pancreatitis history: a nationwide cohort study

Jang, Dong Kee; Choi, Jung-Won; Paik, Woo Hyun; Ryu, Ji Kon; Kim, Yong‐Tae; Han, Kyungdo; Lee, Sang Hyub

doi:10.1038/s41598-022-21852-7

Cited by 8 publications

(10 citation statements)

References 32 publications

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“…Diabetes as a major complication of pancreatitis have been associated with an increased risk of CVD, 37 which supports the link from pancreatitis to an excessive risk of CVD. This link was also directly identified in some previous cohort studies 38,39 as well as in our findings. Gallstone disease has been consistently associated with an increased risk of CVD.…”

Section: Discussionsupporting

confidence: 91%

Risk of incident cardiovascular disease among patients with gastrointestinal disorder: prospective cohort study of 340,862 individuals

Chen

Sun

et al. 2023

Preprint

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Background and Aims The associations between gastrointestinal diseases (GIs) and cardiovascular disease (CVD) were unclear. We conducted a prospective cohort study to explore their associations. Methods This study included 340,862 individuals without baseline CVD from the UK Biobank cohort. Individuals with and without GIs were followed up until the ascertainment of incident CVDs, including coronary heart disease (CHD), cerebrovascular disease (CeVD), and peripheral artery disease (PAD). The diagnosis of diseases was confirmed with combination of the nationwide inpatient data, primary care data, and cancer registries. A multivariable Cox proportional hazard regression model was used to estimate the associations between GIs and the risk of incident CVD. Results During a median follow-up of 12.4 years, 28,787 incident CVD cases were diagnosed. Individuals with GIs had an elevated risk of CVD (hazard ratio 1.38; 95% confidence interval 1.35-1.42, P<0.001). Eleven out of fifteen GIs were associated with an increased risk of CVD after Bonferroni-correction, including cirrhosis, non-alcoholic fatty liver disease, gastritis and duodenitis, irritable bowel syndrome, gastroesophageal reflux disease, peptic ulcer, celiac disease, pancreatitis, diverticular disease, biliary disease, and appendicitis. The associations were stronger among women, individuals aged ≤ 60 years, and those with body mass index ≥ 25 kg/m2. Conclusions This large-scale prospective cohort study revealed the associations of GIs with an increased risk of incident CVD, in particular CHD and PAD. These findings support the reinforced secondary CVD prevention among patients with gastrointestinal disorders.

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Section: Discussionsupporting

confidence: 91%

Risk of incident cardiovascular disease among patients with gastrointestinal disorder: prospective cohort study of 340,862 individuals

Chen

Sun

et al. 2023

Preprint

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“…With the prevalence of T2DM worldwide, its side effects and risks are more visible, and this has caused more concerns (3). One complication traditionally associated with T2DM, the risk of which has increased significantly, is cardiovascular disease (4,5). Meanwhile, diabetic cardiomyopathy is one of the main and most important complications of T2DM; the pathogenesis and clinical features of diabetic cardiomyopathy has been well studied in the last decade, but effective approaches to prevent and treat this disease are limited (6).…”

Section: Introductionmentioning

confidence: 99%

Highlighting the novel effects of high-intensity interval training on some histopathological and molecular indices in the heart of type 2 diabetic rats

Rami,

Rahdar,

Ahmadi Hekmatikar

et al. 2023

Front. Endocrinol.

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BackgroundType 2 diabetes is one of the most common metabolic diseases in recent years and has become an important risk factor for cardiovascular disorders. The first goal is to reduce type 2 diabetes, and in the case of cardiovascular disease, the second goal is to reduce and manage that disorder.Materials and methodsThe rats were divided into 4 groups: Healthy Control (n=8), Diabetes Control (n=8), Diabetes Training (n=8), and Healthy Training (n=8). The protocol consisted of 8 weeks of High-intensity interval (5 sessions per week), where the training started with 80% of the peak speed in the first week, and 10% was added to this speed every week. To measure the level of B-catenin, c-MYC, GSK3B, and Bcl-2 proteins using the western blot method, cardiac pathological changes were measured using hematoxylin and eosin staining, Masson’s trichrome and PAS staining and apoptosis using the TUNEL method.FindingsHistological results showed that diabetes causes significant pathological hypertrophy, fibrosis, and severe apoptosis in heart tissue. HIIT training significantly reduced pathological hypertrophy and fibrosis in heart tissue, and the rate of cardiomyocyte apoptosis was greatly reduced. This research showed that diabetes disorder increases the levels of B-catenin and c-Myc proteins and causes a decrease in the expression of GSK3B and Bcl-2 proteins. After eight weeks of HIIT training, the levels of B-catenin and c-Myc proteins decreased significantly, and the levels of GSK3B and Bcl-2 proteins increased.ConclusionThis study showed that HIIT could be a suitable strategy to reduce cardiomyopathy in type 2 diabetic rats. However, it is suggested that in future studies, researchers should perform different intensities and exercises to promote exercise goals in type 2 diabetic cardiomyopathy.

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“…Additionally, elevated glucose levels during hospitalization are associated with more severe AP episodes and increased mortality rates ( 3 ). Moreover, it is gaining recognition that DM might also develop after AP as a potential long-term complication ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

“…Not only is the risk of these conditions substantially increased in the context of AP, but their therapy is also challenging. Post-AP DM is recognized as a distinct subtype of DM ( 9 ) with more frequent hypoglycemic events ( 10 , 11 ) and simultaneously greater insulin needs ( 5 , 12 , 13 ) than type 2 DM.…”

Section: Introductionmentioning

confidence: 99%

“…Studies focusing on acute pancreatitis patients with extended follow-up periods are limited ( 14 ) and investigations into the implications of developing post-AP DM are even more scarce. Compared to type 2 DM, post-AP DM carries a higher risk of cardiovascular and cerebrovascular disease based on cohort studies exceeding 150,000 patients ( 5 , 11 ). A population-based matched cohort study of 10,549 individuals in New Zealand reported higher cancer-related deaths (not including pancreatic cancer) and increased mortality from gastrointestinal and infectious diseases in patients with post-AP DM compared to type 2 DM ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis

Zahariev,

Bunduc,

Kovács

et al. 2024

Front. Med.

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IntroductionWithin 5 years of having acute pancreatitis (AP), approximately 20% of patients develop diabetes mellitus (DM), which later increases to approximately 40%. Some studies suggest that the prevalence of prediabetes (PD) and/or DM can grow as high as 59% over time. However, information on risk factors is limited. We aimed to identify risk factors for developing PD or DM following AP.MethodsWe systematically searched three databases up to 4 September 2023 extracting direct, within-study comparisons of risk factors on the rate of new-onset PD and DM in AP patients. When PD and DM event rates could not be separated, we reported results for this composite outcome as PD/DM. Meta-analysis was performed using the random-effects model to calculate pooled odds ratios (OR) with 95% confidence intervals (CI).ResultsOf the 61 studies identified, 50 were included in the meta-analysis, covering 76,797 participants. The studies reported on 79 risk factors, and meta-analysis was feasible for 34 risk factor and outcome pairs. The odds of developing PD/DM was significantly higher after severe and moderately severe AP (OR: 4.32; CI: 1.76–10.60) than mild AP. Hypertriglyceridemic AP etiology (OR: 3.27; CI: 0.17–63.91) and pancreatic necrosis (OR: 5.53; CI: 1.59–19.21) were associated with a higher risk of developing PD/DM. Alcoholic AP etiology (OR: 1.82; CI: 1.09–3.04), organ failure (OR: 3.19; CI: 0.55–18.64), recurrent AP (OR: 1.89; CI: 0.95–3.77), obesity (OR: 1.85; CI: 1.43–2.38), chronic kidney disease (OR: 2.10; CI: 1.85–2.38), liver cirrhosis (OR: 2.48; CI: 0.18–34.25), and dyslipidemia (OR: 1.82; CI: 0.68–4.84) were associated with a higher risk of developing DM.DiscussionSevere and moderately severe AP, alcoholic and hypertriglyceridemic etiologies, pancreatic necrosis, organ failure, recurrent acute pancreatitis and comorbidities of obesity, chronic kidney disease liver disease, and dyslipidemia are associated with a higher risk of developing PD or DM.Systematic review registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42021281983.

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Risk of cardiovascular disease and mortality in patients with diabetes and acute pancreatitis history: a nationwide cohort study

Cited by 8 publications

References 32 publications

Risk of incident cardiovascular disease among patients with gastrointestinal disorder: prospective cohort study of 340,862 individuals

Risk of incident cardiovascular disease among patients with gastrointestinal disorder: prospective cohort study of 340,862 individuals

Highlighting the novel effects of high-intensity interval training on some histopathological and molecular indices in the heart of type 2 diabetic rats

Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis

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