Pancreas
Clin Gastroenterol Hepatol. 2023;21(5):1214−22.e14
Association of statin usage and the development of diabetes mellitus after acute pancreatitis
Background: Patients with acute pancreatitis (AP) have at least a 2-fold higher risk for developing post-pancreatitis diabetes mellitus (PPDM). No therapies have prevented PPDM. Statins were demonstrated to possibly lower the incidence and severity of AP but have not been studied to prevent PPDM.
Methods: Data from a commercial insurance claim database (Optum Clinformatics) were used to assess the impact of statins on patients without pre-existing DM admitted for a first episode of AP in 118,479 patients. Regular statin usage was defined as filled statin prescriptions for at least 80% of the year prior to AP. The primary outcome was defined as PPDM. The authors constructed a propensity score and applied inverse proba-bility of treatment weighting to balance baseline characteristics between groups. Using Cox proportional hazards regression modeling, they esti-mated the risk of PPDM, accounting for competing events.
Results: With a median of 3.5 years of follow-up, the 5-year cumulative incidence of PPDM was 7.5% (95% confidence interval [CI]: 6.9−8.0%) among regular statin users and 12.7% (95% CI: 12.4−12.9%) among non-users. Regular statin users had a 42% lower risk of developing PPDM compared with non-users (hazard ratio [HR] = 0.58; 95% CI: 0.52−0.65; p < 0.001). Irregular statin users had a 15% lower risk of PPDM (HR = 0.85; 95% CI: 0.81−0.89; p < 0.001). Similar benefits were seen with low, moderate, and high statin doses.
Conclusions: In a large database-based study, statin usage reduced the risk of developing diabetes mellitus (DM) after acute pancreatitis (AP). Further prospective studies with long-term follow-up are needed to study the impact of statins on AP and prevention of post-pancreatitis DM.