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Sakina H Bharmal, Wandia Kimita, Juyeon Ko, and Maxim S Petrov

Objective: Early identification of individuals at a high risk for metabolic derangements after an attack of acute pancreatitis (AP) is critical with a view to tertiary preventing of this disease. The aim was to investigate whether fasting pancreatic and gut hormones at baseline were predictive of future risk of new-onset prediabetes after acute pancreatitis (NOPAP) in individuals with non-necrotising AP.

Methods: This was a prospective longitudinal cohort study that included 69 consecutive non-diabetic participants with AP, of whom 55% (n=38) had normoglycaemia both at baseline and during follow-up, 25% (n=17) had prediabetes both at baseline and during follow-up, and 20% (n=14) were normoglycaemic at baseline but developed NOPAP during follow-up. The associations between the study groups and circulating fasting levels of pancreatic and gut hormones (insulin, C-peptide, glucose-dependent insulinotropic peptide, glucagon-like peptide-1, pancreatic polypeptide, and peptide YY) were studied using multinomial regression in both unadjusted and adjusted analyses.

Results: Elevated plasma insulin and glucagon at baseline were significantly associated with NOPAP (adjusted odds ratio 1.99, 95% confidence interval 1.01 to 3.92; and adjusted odds ratio 3.44, 95% confidence interval 1.06 to 11.19, respectively). The same hormones had no significant association with antecedent prediabetes in AP. The other studied hormones were not significantly associated with the study groups.

Conclusions: Normoglycaemic AP individuals with elevated fasting levels of insulin and glucagon at baseline constitute a high-risk group for future NOPAP.