PT  - JOURNAL ARTICLE
AU  - Menghua Dai
AU  - Cheng Xing
AU  - Ning Shi
AU  - Shunda Wang
AU  - Guangdong Wu
AU  - Quan Liao
AU  - Taiping Zhang
AU  - Ge Chen
AU  - Wenming Wu
AU  - Junchao Guo
AU  - Ziwen Liu
TI  - Risk factors for new-onset diabetes mellitus after distal pancreatectomy
AID  - 10.1136/bmjdrc-2020-001778
DP  - 2020 Oct 01
TA  - BMJ Open Diabetes Research & Care
PG  - e001778
VI  - 8
IP  - 2
4099  - http://drc.bmj.com/content/8/2/e001778.short
4100  - http://drc.bmj.com/content/8/2/e001778.full
SO  - BMJ Open Diab Res Care2020 Oct 01; 8
AB  - Introduction Several previous studies have reported the incidence of new-onset diabetes mellitus (NODM) after pancreatectomy. Nevertheless, the results were inconsistent. The true rate of NODM after distal pancreatectomy (DP) is still unknown.Research design and methods The aim of this study was to investigate the incidence of and the risk factors for NODM after DP. This study enrolled patients who underwent DP between January 2004 and February 2016 at Peking Union Medical College Hospital. Patients with preoperative diabetes mellitus or diagnosed with pancreatic cancer were excluded. The primary outcome was NODM.Results A total of 485 patients were enrolled. The median (IQR) of follow-up duration was 30.95 (9.26–180.30) months. The accumulative incidence of NODM was 8.9% at postoperative 6 months, 14.0% at postoperative year one, 22.3% at year three, 27.1% at year five, and 35.5% at year ten. Multivariate analysis showed that the risk of postoperative NODM was positively correlated with age (HR 1.029 (1.013–1.045), p<0.001), preoperative body mass index (BMI) (HR 1.042 (1.003–1.083), p=0.001), operative blood loss (HR 1.0003 (1.0002–1.0010), p<0.001), and length of resected pancreas (HR 1.079 (1.013–1.148), p=0.017). Moreover, concomitant splenectomy (HR 2.001 (1.202–3.331), p=0.008) was associated with significantly higher risk of postoperative NODM.Conclusion NODM incidence increased with postoperative time progression. Age, BMI, surgical blood loss, length of resected pancreas and splenectomy were independent risk factors for NODM after DP.Trial registration number NCT03030209.