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The Association Between Diabetes Mellitus and Perianal Abscess: A Meta-Analysis.

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  • 1Graduate School of Clinical Medical College of Traditional Chinese Medicine, Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, People's Republic of China.

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Diabetes mellitus (DM) significantly increases perianal abscess (PA) risk, with bidirectional links and distinct clinical profiles. Male sex, specific microbial changes, and higher recurrence rates are associated with DM and PA.

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Area of Science:

  • Gastroenterology and Hepatology
  • Endocrinology
  • Infectious Diseases

Background:

  • Perianal abscess (PA) is a common anorectal emergency affecting 2-3% of the global population.
  • Growing evidence links PA to metabolic disorders, particularly diabetes mellitus (DM).
  • Projected rise in DM cases to 1 billion by 2045 underscores the need to understand DM-PA associations.

Purpose of the Study:

  • To investigate the bidirectional epidemiological relationship between DM and PA.
  • To define the distinct clinical characteristics of PA in patients with and without DM.
  • To contribute to improved risk stratification and management strategies for PA and DM.

Main Methods:

  • Systematic retrieval of observational studies on DM and PA from major databases (PubMed, EMBASE, etc.) up to November 2024.
  • Independent study selection, data extraction, and quality assessment using the Newcastle-Ottawa Scale.
  • Meta-analysis using random-effects models to calculate pooled prevalence, OR, RR, and CI, with heterogeneity and bias assessments.

Main Results:

  • A strong bidirectional association was found: 30.7% of PA cases occurred in DM patients, and 22.0% of DM patients developed PA.
  • Male sex significantly increased PA risk in DM patients (OR=15.00).
  • DM was associated with altered gut microbiota (decreased *Escherichia coli*, increased *Klebsiella pneumoniae*), higher abscesses, earlier onset, and increased recurrence.

Conclusions:

  • DM and PA exhibit mutual risk amplification and unique clinical features, including sex-specific vulnerability and microbial shifts.
  • Patients with DM present with distinct PA manifestations and poorer prognostic outcomes.
  • Individualized antimicrobial strategies and enhanced postoperative monitoring are crucial for DM patients with PA.