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Obesity and glyburide use associated with the acute pancreatitis risk

NEW YORK (Reuters Health) – Obesity and the use of glyburide appear to be risk factors for acute pancreatitis, according to a report in the February issue of Diabetes Care.

Using data from a population-based, case-control study of 1.4 million adult inhabitants of Sweden, Dr. Bengt E. Wiholm, of Karolinska Institutet, Stockholm, and colleagues examined the risk factors for acute pancreatitis, particularly those associated with drug use.

"A total of 462 case subjects were hospitalized in surgery departments for their first episode of acute pancreatitis without previous gallbladder disease," the team explains. "A total of 1781 control subjects were randomly selected from a population register." The investigators reviewed case records and conducted telephone interviews to collect information.

Prevalent diabetes was observed in 27 cases (6%) and 55 controls (3%). Fifty-three cases (11%) had a body mass index (BMI) of greater than 30 kg/meters squared, compared with 130 controls (7%).

Glyburide use was associated with a crude odds ratio of 3.2 for the development of acute pancreatitis. After adjusting for covariates, multivariate logistic regression showed an odds ratio of 2.5 for the use of glyburide.

"BMI had a continuous odds ratio of 1.2 per 5 units of BMI," the investigators note. Compared with patients with a BMI between 20 and 25 kg/meters squared, those with a BMI greater than 30 kg/meters squared had a relative risk of 2.4 for hospitalization longer than 14 days or treatment in an intensive care unit.

"It may still be prudent to carefully consider the choice of antidiabetes treatment in patients with risk factors for acute pancreatitis," Dr. Wiholm and colleagues conclude. It may also "be of clinical value to determine the BMI in addition to previous parameters…for prediction of the clinical course when patients with acute pancreatitis are hospitalized."

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