Prospective Study of Alcohol Drinking, Smoking, and Pancreatitis: The Multiethnic Cohort.
Prospective Study of Alcohol Drinking, Smoking, and Pancreatitis: The Multiethnic Cohort.
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DOI：
10.1097/mpa.0000000000000657
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发表时间：
2016-07
期刊：
影响因子：
2.9
通讯作者：
Monroe KR
中科院分区：
文献类型：
--
作者：
Setiawan VW;Pandol SJ;Porcel J;Wilkens LR;Le Marchand L;Pike MC;Monroe KR
我们对多种族队列中的145,886名参与者进行了前瞻性分析，以考察饮酒和吸烟与胰腺炎的关系。胆石性急性胰腺炎(GS AP)1 065例，非GS AP 1 222例，复发性急性胰腺炎(RAP)/慢性胰腺炎(CP)523例。我们使用基线问卷来确定酒精摄入量和吸烟史。使用COX模型通过风险比(HR)和95%可信区间(CI)来估计关联性。吸烟与非GS AP和RAP/CP相关。在女性中，适量饮酒与所有类型的胰腺炎呈负相关(每天喝1杯酒的HRs=0.66~0.81)，在男性中与RAP/CP呈负相关(HR=0.57；95%CI：0.41，每天喝2杯酒的HR0.79)。在每天饮酒的男性中，与当前吸烟相关的非GS胰腺炎的风险最高(HR=2.06；95%CI：1.28，3.30)，而在从不吸烟的男性中，适度饮酒与风险降低相关(HR=0.70；95%CI：0.51，0.96)。在女性中，在从不吸烟的人中，每天饮酒2杯与GS-AP风险降低相关(HR=0.61；95%CI：0.46，0.80)。吸烟是非GS胰腺炎的危险因素。适量饮酒对女性所有类型的胰腺炎和男性的RAP/CP都有保护作用。
We conducted a prospective analysis of 145,886 participants in the Multiethnic Cohort to examine the relationship of alcohol drinking and smoking with pancreatitis. Pancreatitis cases were categorized as gallstone-related acute pancreatitis (GS AP) (N=1,065), non-GS AP (N=1,222), and recurrent acute (RAP)/chronic pancreatitis (CP) (N=523). We used the baseline questionnaire to identify alcohol intake and smoking history. Associations were estimated by hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox models. Cigarette smoking was associated with non-GS AP and RAP/CP. Moderate alcohol intake was inversely associated with all types of pancreatitis in women (HRs=0.66 to 0.81 for <1 drink/day), and with RAP/CP in men (HR=0.57; 95% CI: 0.41, 0.79 for <2 drinks/day). The risk of non-GS pancreatitis associated with current smoking was highest among men who consumed >4 drinks/day (HR=2.06; 95% CI: 1.28, 3.30), while among never-smokers, moderate drinking was associated with a reduced risk (HR=0.70; 95% CI: 0.51, 0.96). In women, drinking <2 drinks/day was associated with a reduced risk of GS-AP among never smokers (HR=0.61; 95% CI: 0.46, 0.80). Smoking is a risk factor for non-GS pancreatitis. Moderate alcohol intake is protective against all types of pancreatitis in women and against RAP/CP in men.