Evidence mapPaperPMID 40689790Full record

ArticlePancreas2025

Significance of Pancreatic Steatosis as a Predictor of New-Onset Diabetes Mellitus Following Pancreatectomy.

Keinosuke Ishido, Hiroaki Fujita, Norihisa Kimura, Hayato Nagase, Yusuke Wakasa, Satoru Tsuruta, Takahiro Muroya, Kenichi Hakamada

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Article in Pancreas, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Keinosuke IshidoDepartment of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan.
Hiroaki Fujita
Norihisa Kimura
Hayato Nagase
Yusuke Wakasa
Satoru Tsuruta
Takahiro Muroya
Kenichi Hakamada

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite advancements in pancreatic surgery, new-onset diabetes mellitus following pancreatectomy (NODMP), persists, affecting patients' quality of life. Predicting NODMP before surgery could significantly enhance postoperative care.

methodsThis study included 220 patients who underwent pancreatoduodenectomy or distal pancreatectomy at Hirosaki University Hospital between January 2008 and December 2020. Patients with preoperative diabetes or <6 months' follow-up were excluded. The anticipated remnant pancreatic-to-splenic parenchyma computed tomography value ratio (remP/S ratio) was used to assess pancreatic fat content, with its cutoff determined using the receiving operator characteristic curve. Time to diabetes onset was analyzed using the Kaplan-Meier method. The risk factors for NODMP were identified using the Cox proportional hazards model.

resultsThe mean diabetes-free period was 89.2 months over a median follow-up of 25.1 months. The incidence rates of NODMP at 1, 3, and 5 years after resection were 7.21%, 21.3%, and 28.0%, respectively. The significant risk factors for NODMP identified by univariate analysis were pancreatic cancer, preoperative HbA1c >5.7%, remP/S ratio <0.66, and remnant pancreatic volume <32.7 cm3. Multivariate analysis confirmed that a remP/S ratio <0.66 and preoperative HbA1c >5.7% were independent predictors of NODMP. The risk scoring system indicated that patients with both risk factors have a fivefold higher risk of developing NODMP within 2 years compared with those without either risk factor.

conclusionsPreoperative remP/S ratio and HbA1c were significant predictors of NODMP, enabling the effective stratification of NODMP risk and facilitating the early treatment of the disease.

Indexed as

attenuation of computed tomographynew-onset diabetes mellituspancreatectomyPancreatic steatosisrisk factor analysis

Identifiers

PMID40689790
PMCPMC12419024

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