Risk factors associated with acute pancreatitis in diabetic ketoacidosis patients: a 11-year experience in a single tertiary medical center and comprehensive literature review

ObjectiveTo identify independent risk factors and predictive markers for acute pancreatitis (AP) in patients with diabetic ketoacidosis (DKA).MethodsHere, we reported a 11-year experience in a single tertiary medical center and conduct a systematic review of acute pancreatitis in diabetic ketoacidos...

Full description

Saved in:
Bibliographic Details
Main Authors: Yifei Chen, Yan Bo, Zhuanzhuan Han, Mengjie Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1571631/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850266078150656000
author Yifei Chen
Yan Bo
Zhuanzhuan Han
Mengjie Chen
author_facet Yifei Chen
Yan Bo
Zhuanzhuan Han
Mengjie Chen
author_sort Yifei Chen
collection DOAJ
description ObjectiveTo identify independent risk factors and predictive markers for acute pancreatitis (AP) in patients with diabetic ketoacidosis (DKA).MethodsHere, we reported a 11-year experience in a single tertiary medical center and conduct a systematic review of acute pancreatitis in diabetic ketoacidosis patients (DKA-AP). 1,941 cases were included. First retrospective cohort study analyzed clinical data from 45 patients with DKA-AP and 45 matched controls with DKA alone (DKA-nonAP) admitted to Yangzhou University Affiliated Hospital (2013–2024). Baseline characteristics included BMI, hyperlipidemia history, and serological profiles. Secondly we retrieved clinical studies of DKA-AP from PubMed database system and analyzed these clinical data in depth.ResultsSignificant differences were observed in BMI: median [IQR] = 26.30 [22.15–28.40] vs. 23.20 [20.70–25.35] kg/m2, p = 0.031, hyperlipidemia history (26.7% vs. 4.4%, p = 0.004), abdominal pain duration (3 vs. 0 days, p < 0.001), and lipid profiles TC: median [IQR] = 7.71 [5.60–11.66] vs. 4.86 [4.22–6.52] mmol/L, p < 0.001; TG: median [IQR] = 11.90 [4.71–15.84] vs. 1.60 [0.89–3.64] mmol/L, p < 0.001. Logistic regression identified TC (OR = 1.455, 95% CI: 1.196–1.769), TG (OR = 2.046, 95% CI: 1.202–3.484), and abdominal pain duration (OR = 3.892, 95% CI: 2.173–6.972) as independent risk factors. Receiver operating characteristic curve (ROC) analysis demonstrated strong predictive performance (combined AUC = 0.933, sensitivity = 93.3%, specificity = 73.3%). Moreover, we found 11 clinical studies investigating DKA-AP. Cumulatively, 1,851 patients were studied, including 3 interventional studies, 1 genetic observational study, and 7 cohort studies exploring risk factors.ConclusionElevated TC, TG, and prolonged abdominal pain duration are key predictors of DKA-AP. These factors enhance early diagnosis and clinical management in Yangzhou, China.
format Article
id doaj-art-9436d6bef8234fec90a04088b762c0ee
institution OA Journals
issn 2296-858X
language English
publishDate 2025-04-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-9436d6bef8234fec90a04088b762c0ee2025-08-20T01:54:16ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-04-011210.3389/fmed.2025.15716311571631Risk factors associated with acute pancreatitis in diabetic ketoacidosis patients: a 11-year experience in a single tertiary medical center and comprehensive literature reviewYifei Chen0Yan Bo1Zhuanzhuan Han2Mengjie Chen3The Department of Emergency Medicine, The Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, ChinaThe Department of Medicine, Northwest Minzu University, Lanzhou, Gansu, ChinaThe Department of Emergency Medicine, The Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, ChinaThe Department of Medicine, Dalian Medical University, Dalian, Liaoning, ChinaObjectiveTo identify independent risk factors and predictive markers for acute pancreatitis (AP) in patients with diabetic ketoacidosis (DKA).MethodsHere, we reported a 11-year experience in a single tertiary medical center and conduct a systematic review of acute pancreatitis in diabetic ketoacidosis patients (DKA-AP). 1,941 cases were included. First retrospective cohort study analyzed clinical data from 45 patients with DKA-AP and 45 matched controls with DKA alone (DKA-nonAP) admitted to Yangzhou University Affiliated Hospital (2013–2024). Baseline characteristics included BMI, hyperlipidemia history, and serological profiles. Secondly we retrieved clinical studies of DKA-AP from PubMed database system and analyzed these clinical data in depth.ResultsSignificant differences were observed in BMI: median [IQR] = 26.30 [22.15–28.40] vs. 23.20 [20.70–25.35] kg/m2, p = 0.031, hyperlipidemia history (26.7% vs. 4.4%, p = 0.004), abdominal pain duration (3 vs. 0 days, p < 0.001), and lipid profiles TC: median [IQR] = 7.71 [5.60–11.66] vs. 4.86 [4.22–6.52] mmol/L, p < 0.001; TG: median [IQR] = 11.90 [4.71–15.84] vs. 1.60 [0.89–3.64] mmol/L, p < 0.001. Logistic regression identified TC (OR = 1.455, 95% CI: 1.196–1.769), TG (OR = 2.046, 95% CI: 1.202–3.484), and abdominal pain duration (OR = 3.892, 95% CI: 2.173–6.972) as independent risk factors. Receiver operating characteristic curve (ROC) analysis demonstrated strong predictive performance (combined AUC = 0.933, sensitivity = 93.3%, specificity = 73.3%). Moreover, we found 11 clinical studies investigating DKA-AP. Cumulatively, 1,851 patients were studied, including 3 interventional studies, 1 genetic observational study, and 7 cohort studies exploring risk factors.ConclusionElevated TC, TG, and prolonged abdominal pain duration are key predictors of DKA-AP. These factors enhance early diagnosis and clinical management in Yangzhou, China.https://www.frontiersin.org/articles/10.3389/fmed.2025.1571631/fulldiabetic ketoacidosisacute pancreatitispancreatitisrisk factorsdiagnosis
spellingShingle Yifei Chen
Yan Bo
Zhuanzhuan Han
Mengjie Chen
Risk factors associated with acute pancreatitis in diabetic ketoacidosis patients: a 11-year experience in a single tertiary medical center and comprehensive literature review
Frontiers in Medicine
diabetic ketoacidosis
acute pancreatitis
pancreatitis
risk factors
diagnosis
title Risk factors associated with acute pancreatitis in diabetic ketoacidosis patients: a 11-year experience in a single tertiary medical center and comprehensive literature review
title_full Risk factors associated with acute pancreatitis in diabetic ketoacidosis patients: a 11-year experience in a single tertiary medical center and comprehensive literature review
title_fullStr Risk factors associated with acute pancreatitis in diabetic ketoacidosis patients: a 11-year experience in a single tertiary medical center and comprehensive literature review
title_full_unstemmed Risk factors associated with acute pancreatitis in diabetic ketoacidosis patients: a 11-year experience in a single tertiary medical center and comprehensive literature review
title_short Risk factors associated with acute pancreatitis in diabetic ketoacidosis patients: a 11-year experience in a single tertiary medical center and comprehensive literature review
title_sort risk factors associated with acute pancreatitis in diabetic ketoacidosis patients a 11 year experience in a single tertiary medical center and comprehensive literature review
topic diabetic ketoacidosis
acute pancreatitis
pancreatitis
risk factors
diagnosis
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1571631/full
work_keys_str_mv AT yifeichen riskfactorsassociatedwithacutepancreatitisindiabeticketoacidosispatientsa11yearexperienceinasingletertiarymedicalcenterandcomprehensiveliteraturereview
AT yanbo riskfactorsassociatedwithacutepancreatitisindiabeticketoacidosispatientsa11yearexperienceinasingletertiarymedicalcenterandcomprehensiveliteraturereview
AT zhuanzhuanhan riskfactorsassociatedwithacutepancreatitisindiabeticketoacidosispatientsa11yearexperienceinasingletertiarymedicalcenterandcomprehensiveliteraturereview
AT mengjiechen riskfactorsassociatedwithacutepancreatitisindiabeticketoacidosispatientsa11yearexperienceinasingletertiarymedicalcenterandcomprehensiveliteraturereview