{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:44:43Z","timestamp":1787168683685,"version":"build-2736575974"},"reference-count":34,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012266","name":"National Research Foundation","doi-asserted-by":"publisher","award":["2022R1A2C2004570"],"award-info":[{"award-number":["2022R1A2C2004570"]}],"id":[{"id":"10.13039\/501100012266","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Korea Pancreas Surgery Club","award":["KPSC-2020-002"],"award-info":[{"award-number":["KPSC-2020-002"]}]},{"name":"Seoul National University Hostpital","award":["04-2022-0510"],"award-info":[{"award-number":["04-2022-0510"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>With advancements in long-term survival after pancreatectomy, postpancreatectomy diabetes has become a concern, and the risk factors are not yet established. Pancreatic islets are susceptible to ischemic damage, though there is a lack of clinical evidence regarding glycemic deterioration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate association between hypotension during pancreatectomy and development of postpancreatectomy diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>In this retrospective, longitudinal cohort study, we enrolled patients without diabetes who underwent distal pancreatectomy or pancreaticoduodenectomy between January 2005 and December 2018 from 2 referral hospitals in Korea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Intraoperative hypotension (IOH) was defined as a 20% or greater reduction in systolic blood pressure. The primary and secondary outcomes were incident diabetes and postoperative Homeostatic Model Assessment (HOMA) indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We enrolled 1129 patients (average age, 59 years; 49% men; 35% distal pancreatectomy). IOH occurred in 83% (median duration, 25\u2005minutes; interquartile range, 5-65). During a median follow-up of 3.9 years, diabetes developed in 284 patients (25%). The cumulative incidence of diabetes was proportional to increases in the duration and depth of IOH (P &amp;lt; .001). For the median duration in IOH compared with a reference time of 0\u2005minutes, the hazard ratio was 1.48 (95% CI, 1.14-1.92). The effect of IOH was pronounced with distal pancreatectomy. Furthermore, the duration of IOH was inversely correlated with 1-year HOMA \u03b2-cell function (P &amp;lt; .002), but not with HOMA insulin resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These results support the hypothesis that IOH during pancreatectomy may elevate risk of diabetes by inducing \u03b2-cell insufficiency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgae227","type":"journal-article","created":{"date-parts":[[2024,4,6]],"date-time":"2024-04-06T03:08:43Z","timestamp":1712372923000},"page":"e249-e256","source":"Crossref","is-referenced-by-count":4,"title":["Association Between Hypotension During Pancreatectomy and Development of Postoperative Diabetes"],"prefix":"10.1210","volume":"110","author":[{"given":"Seoil","family":"Moon","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of 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