Bidirectional relationship between gout and diabetes mellitus in individuals after acute pancreatitis: a nationwide cohort study.

Individuals after acute pancreatitis are often characterised by low-grade inflammation and, hence, frequently develop metabolic sequelae such as post-pancreatitis diabetes mellitus (PPDM). The relationship between gout and type 2 diabetes was studied before; however, little is known about the relationship between gout and PPDM. The aim was to investigate the associations between gout and PPDM in individuals following acute pancreatitis.Using nationwide pharmaceutical dispensing data linked to hospital discharge data in New Zealand, gout and PPDM were identified among individuals after first episode of acute pancreatitis between January 1, 2007 and December 31, 2015. Multivariable Cox regression analyses were conducted, adjusting for age, sex, ethnicity, social deprivation index, alcohol consumption, tobacco smoking, comorbidities, medications (glucocorticoids, statins, and oestrogens), and characteristics of acute pancreatitis.A total of 10,117 individuals were included in the analysis of risk for gout and 9,471 in the analysis of risk for PPDM. PPDM was significantly associated with a higher risk of gout in the overall cohort (adjusted hazard ratio, 1.88; 95% confidence interval, 1.15-3.06) and women (2.72; 1.31-5.65), but not in men (1.42; 0.73-2.78). Pre-existing gout was significantly associated with a higher risk of PPDM in the overall cohort (adjusted hazard ratio, 1.58; 95% confidence interval, 1.04-2.41) and women (2.66; 1.29-5.49), but not in men (1.31; 0.78-2.20).The relationship between gout and PPDM is bidirectional in the postpancreatitis setting. A prior history of gout is a risk factor of PPDM, particularly in women.