Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis.
Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis.
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DOI：
10.1001/archinternmed.2009.125
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发表时间：
2009-06-08
影响因子：
--
通讯作者：
North American Pancreatic Study Group
中科院分区：
文献类型：
--
作者：
Yadav D;Hawes RH;Brand RE;Anderson MA;Money ME;Banks PA;Bishop MD;Baillie J;Sherman S;DiSario J;Burton FR;Gardner TB;Amann ST;Gelrud A;Lawrence C;Elinoff B;Greer JB;O'Connell M;Barmada MM;Slivka A;Whitcomb DC;North American Pancreatic Study Group
复发性急性胰腺炎(RAP)和慢性胰腺炎(CP)与饮酒和吸烟有关。RAP和CP的病因很复杂，酒精和吸烟的影响可能仅限于特定的患者亚群。我们调查了在美国转诊中心接受评估的患者的酒精使用、吸烟及其与RAP和CP之间的关系。北美胰腺炎研究-2是一个由20个美国中心组成的多中心联盟，在2000-2006年间前瞻性地招募了540名CP、460名RAP患者和695名对照。根据自己报告的在一生最大饮酒期内每月饮酒量，我们将饮酒状态归类为“戒酒者”、“轻度”(≤为每天0.5杯)、“中度”(女性：0.5-1，男性：0.5-2)、“重度”(女性：1-5，男性：2-5)或“非常重度”(≥5，男女均为)。吸烟被归类为“从不”、“过去”或“现在”，并被量化(每包/天，包年)。总体而言，参与者的平均年龄为49.7±15.4岁；87.5%是白人，56.5%是女性。在对照组和患者中，大约有四分之一的人是终生戒酒者。重度饮酒率男性和女性分别为38.4%和11%，RAP分别为16.9%和5.5%，对照组分别为10%和3.6%。与戒酒和少量饮酒相比，在控制了年龄、性别、吸烟和体重指数后，重度饮酒与慢性阻塞性肺疾病显著相关(OR 3.10；95%CI 1.87~5.14)。吸烟是CP和RAP的一个独立的、剂量依赖的危险因素。大量饮酒和吸烟是CP的独立危险因素。目前在美国转诊中心就诊的少数胰腺炎患者报告说他们非常酗酒。
Recurrent acute (RAP) and chronic pancreatitis (CP) are associated with alcohol consumption and cigarette smoking. Etiology of RAP and CP is complex, and effects of alcohol and smoking may be limited to specific patient subsets. We examined the current prevalence of alcohol use, smoking and their association with RAP and CP in patients evaluated at US referral centers. The North American Pancreatitis Study-2, a multicenter consortium of 20 US centers prospectively enrolled 540 CP, 460 RAP patients and 695 controls from 2000–2006. Using self-reported monthly alcohol consumption during the maximum lifetime drinking period, we classified drinking status as “abstainer”, “light” (≤0.5 drinks/day), “moderate” (females: >0.5–1, males: >0.5–2), “heavy” (females: >1-<5, males: >2-<5), or “very heavy” (≥5, both genders). Smoking was classified as “never”, “past” or “current” and quantified (packs/day, pack years). Overall, participants’ average age was 49.7±15.4 years; 87.5% were white and 56.5% were female. Approximately one-fourth of both controls and patients were lifetime abstainers. The prevalence of very heavy drinking among males and females was 38.4% and 11% for CP; 16.9% and 5.5% for RAP; 10% and 3.6% for controls. Compared to abstaining and light drinking, very heavy drinking was significantly associated with CP (OR 3.10; 95% CI 1.87–5.14) after controlling for age, gender, smoking and BMI. Cigarette smoking was an independent, dose-dependent risk factor for CP and RAP. Very heavy alcohol consumption and smoking are independent risks for CP. A minority of pancreatitis patients currently seen at US referral centers report very heavy drinking.
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