Objective To identify independent risk factors and predictive markers for acute pancreatitis (AP) in patients with diabetic ketoacidosis (DKA).

Methods Here, we reported a 11 year experience in a single tertiary medical center and conduct a systematic review of acute pancreatitis in diabetic ketoacidosis patients cooccurence of DKA and AP. 1941 cases were included. First retrospective cohort study analyzed clinical data from 45 patients with cooccurence of DKA and AP and 45 matched controls with DKA alone admitted to Yangzhou University Affiliated Hospital. Baseline characteristics included BMI, hyperlipidemia history, and serological profiles. Secondly we retrieved clinical studies of cooccurence of DKA and AP from PubMed database system and analysed these clinical data in depth.

Results Significant differences were observed in BMI (26.30 vs. 23.20 kg/m2, p = 0.031), hyperlipidemia history (26.7% vs. 4.4%, p = 0.004), abdominal pain duration (3 vs. 0 days, p < 0.001), and lipid profiles [(TC: 7.71 vs. 4.86 mmol/L); (TG: 11.97 vs. 1.60 mmol/L, p < 0.001)]. Logistic regression identified TC [(OR = 1.455, 95% CI(1.196, 1.769)], TG [(OR = 2.046, 95% CI(1.202, 3.484)], and abdominal pain duration [(OR = 3.892, 95% CI(2.173, 6.972)] as independent risk factors. Receiver operating characteristic curve (ROC) analysis demonstrated strong predictive performance (combined AUC = 0.933, sensitivity = 93.3%, specificity = 73.3%). Moreover, we found 11 clinical studies investigating cooccurence of DKA and AP. Cumulatively, 1851 patients were studied, including 3 interventional studies, 1 genetic observational study, and 7 cohort studies exploring risk factors.

Conclusion Elevated TC, TG, and prolonged abdominal pain duration are key predictors of cooccurence of DKA and AP. These factors enhance early diagnosis and clinical management in Yangzhou, China.

The authors have declared no competing interest.

This study did not receive any funding

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study was approved by the Institutional Ethics Committee of Yangzhou University Affiliated Hospital (2022-YKL3-06-004)

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