Association Between Post-ERCP Pancreatitis and New-Onset Diabetes Mellitus: A Retrospective Cohort Study
Abstract
1. Introduction
2. Methods
2.1. Study Design
2.2. Definitions
2.2.1. Post-ERCP Pancreatitis
2.2.2. Pre-Existing Diabetes Mellitus
2.2.3. New-Onset Diabetes Mellitus
2.3. Ethical Approval
2.4. Statistical Analysis
3. Results
3.1. Study Population
3.2. Risk of New-Onset Diabetes Mellitus
3.3. Multivariable Analysis
3.4. Severity Analysis
3.5. Exploratory Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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| p Value | No PEP (n = 2530) | PEP (n = 165) | |
|---|---|---|---|
| Demographics | |||
| 0.899 | 59.5 ± 18.0 | 59.3 ± 17.8 | Age, mean ± SD |
| 0.208 | 1194 (47.2%) | 69 (41.8%) | Male sex, n (%) |
| <0.001 | 27 (1.1%) | 9 (5.5%) | New-onset diabetes, n (%) |
| Comorbidities | |||
| <0.001 | 669 (26.4%) | 70 (42.4%) | Hypertension, n (%) |
| <0.001 | 231 (9.1%) | 29 (17.6%) | Coronary artery disease, n (%) |
| 0.589 | 58 (2.3%) | 5 (3.0%) | Cerebrovascular disease, n (%) |
| 0.012 | 35 (1.4%) | 7 (4.2%) | Chronic kidney disease, n (%) |
| 0.119 | 81 (3.2%) | 9 (5.5%) | Hyperlipidemia, n (%) |
| 0.206 | 65 (2.6%) | 7 (4.2%) | Hypothyroidism, n (%) |
| 0.022 | 40 (1.6%) | 7 (4.2%) | Dementia, n (%) |
| Procedure characteristics | |||
| 0.001 | 1553 (61.4%) | 122 (73.9%) | Endoscopic sphincterotomy, n (%) |
| 0.023 | 1847 (73.0%) | 107 (64.8%) | Stone/sludge extraction, n (%) |
| 0.005 | 1436 (56.8%) | 112 (67.9%) | Biliary stent placement, n (%) |
| <0.001 | 179 (7.1%) | 27 (16.4%) | Pancreatic stent placement, n (%) |
| 0.778 | 214 (8.5%) | 15 (9.1%) | Balloon dilation, n (%) |
| 0.947 | 79 (3.1%) | 5 (3.0%) | Biopsy, n (%) |
| 95% CI | Estimate | Measure |
|---|---|---|
| 2.44–10.69 | 5.11 | Relative Risk |
| 2.47–11.57 | 5.35 | Odds Ratio |
| 0.9–7.9% | 4.39% | Absolute Risk Increase |
| — | 23 | Number Needed to Harm |
| Model 2 (Age + Sex + HT + CAD) | Model 1 (Age + Sex) | Variable | ||||
|---|---|---|---|---|---|---|
| p | 95% CI | OR | p | 95% CI | OR | |
| Primary predictor | ||||||
| <0.001 | 2.42–11.77 | 5.33 | <0.001 | 2.56–12.06 | 5.56 | Post-ERCP pancreatitis |
| Covariates | ||||||
| 0.716 | 0.97–1.02 | 1 | 0.829 | 0.98–1.02 | 1 | Age (per year) |
| 0.104 | 0.89–3.52 | 1.77 | 0.066 | 0.96–3.73 | 1.89 | Male sex |
| 0.556 | 0.32–1.85 | 0.77 | — | — | — | Hypertension |
| 0.125 | 0.81–5.58 | 2.13 | — | — | — | Coronary artery disease |
| DM Rate (%) | New-Onset DM, n | n | PEP Severity |
|---|---|---|---|
| 5.20% | 8 | 153 | Mild |
| 8.30% | 1 | 12 | Moderately severe |
| p Value | No DM (n = 156) | DM (n = 9) | Variable |
|---|---|---|---|
| Demographics and laboratory | |||
| 0.83 | 62 (45–74) | 64 (53–66) | Age, median (IQR) |
| 0.32 | 96 (78–126) | 120 (99–124) | LDL, median (IQR) |
| 0.20 | 121 (87–155) | 141 (133–146) | Triglycerides, median (IQR) |
| 0.07 | 16 (10–35) | 8 (7–14) | CRP, median (IQR) |
| 0.98 | 8.8 (7.2–11.0) | 8.7 (7.6–10.4) | WBC, median (IQR) |
| 0.41 | 1075 (676–1742) | 789 (678–1023) | Amylase, median (IQR) |
| 0.43 | 1700 (984–2950) | 1206 (988–1566) | Lipase, median (IQR) |
| 0.41 | 7 (6–10) | 8 (7–11) | Hospital stay, median (IQR) |
| Comorbidities and procedure | |||
| 0.49 | 64 (41.0%) | 5 (55.6%) | Male sex, n (%) |
| 1.00 | 66 (42.3%) | 4 (44.4%) | Hypertension, n (%) |
| 0.66 | 27 (17.3%) | 2 (22.2%) | Coronary artery disease, n (%) |
| 1.00 | 7 (4.5%) | 0 | Chronic kidney disease, n (%) |
| 1.00 | 9 (5.8%) | 0 | Hyperlipidemia, n (%) |
| 1.00 | 26 (16.7%) | 1 (11.1%) | Pancreatic stent placement, n (%) |
| 0.72 | 105 (67.3%) | 7 (77.8%) | Biliary stent placement, n (%) |
| 0.16 | 99 (63.5%) | 8 (88.9%) | Stone/sludge extraction, n (%) |
| 0.70 | 116 (74.4%) | 6 (66.7%) | Endoscopic sphincterotomy, n (%) |
| 1.00 | 5 (3.2%) | 0 | Biopsy, n (%) |
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Demir, B.F.; Comoglu, E.; Şahiner, E.S.; Kilic, Z.M.Y.; Ates, I. Association Between Post-ERCP Pancreatitis and New-Onset Diabetes Mellitus: A Retrospective Cohort Study. J. Clin. Med. 2026, 15, 3943. https://doi.org/10.3390/jcm15103943
Demir BF, Comoglu E, Şahiner ES, Kilic ZMY, Ates I. Association Between Post-ERCP Pancreatitis and New-Onset Diabetes Mellitus: A Retrospective Cohort Study. Journal of Clinical Medicine. 2026; 15(10):3943. https://doi.org/10.3390/jcm15103943
Chicago/Turabian StyleDemir, Burak Furkan, Ezgi Comoglu, Enes Seyda Şahiner, Zeki Mesut Yalin Kilic, and Ihsan Ates. 2026. "Association Between Post-ERCP Pancreatitis and New-Onset Diabetes Mellitus: A Retrospective Cohort Study" Journal of Clinical Medicine 15, no. 10: 3943. https://doi.org/10.3390/jcm15103943
APA StyleDemir, B. F., Comoglu, E., Şahiner, E. S., Kilic, Z. M. Y., & Ates, I. (2026). Association Between Post-ERCP Pancreatitis and New-Onset Diabetes Mellitus: A Retrospective Cohort Study. Journal of Clinical Medicine, 15(10), 3943. https://doi.org/10.3390/jcm15103943

