Reassessing the Risk of Pancreatitis With Alcohol.
Reassessing the Risk of Pancreatitis With Alcohol.
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重新评估酒精引起胰腺炎的风险。
DOI：
10.1097/mpa.0000000000000668
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发表时间：
2016
期刊：
影响因子：
2.9
通讯作者：
Yadav,Dhiraj
中科院分区：
文献类型：
--
作者：
Yadav,Dhiraj
大量饮酒（无论何种类型）与急性和慢性胰腺炎之间的关系已得到充分证实。一个明确的关联是一贯表现出来的。1，2是否较低的量或社交饮酒影响这种易感性尚不清楚。即使是低或中等水平的饮酒（每天< 50克）也与急性胰腺炎向慢性胰腺炎的进展有关3，并可改变慢性胰腺炎的自然病程。4酒精相关急性胰腺炎发作后，减少饮酒或完全戒酒可降低复发风险。[5]只有一小部分酗酒者发生胰腺炎，这可能与其固有的易感性有关。酗酒者更有可能是吸烟者，因此最初有人怀疑吸烟在胰腺炎中的作用。吸烟现在被认为是胰腺炎易感性和进展的独立危险因素。8吸烟的影响具有剂量依赖性，并且在伴随酒精暴露的情况下可能更大。酒精，吸烟和胰腺炎之间的关系在以前的社论中已经有了优雅的总结。9，10在这期《胰腺》杂志上发表的一项研究中，Setiawan等人11评估了1993-1996年招募的145，866名多种族受试者中酒精、吸烟和胰腺炎事件之间的关系。参与者在研究开始时完成了一份详细的问卷，包括关于他们饮酒和吸烟习惯的问题。关于酒精暴露的信息仅限于入组前一年。通过各种记录链接确定了2012年因胰腺炎事件住院的患者（n= 2810）。胰腺炎事件分为急性胆结石（37.9%），急性非胆结石（43.5%）和复发性急性或慢性胰腺炎（18.6%）。受试者进入研究时年龄在45 - 75岁之间，从进入研究到因胰腺炎住院的平均时间为10.1年。
The relationship between heavy alcohol consumption, regardless of type, and acute and chronic pancreatitis is well established. A clear association is consistently demonstrated. 1, 2 Whether lower amounts or social drinking influence this susceptibility is less clear. Alcohol consumption even at low or moderate levels (< 50 grams a day) is associated with progression from acute to chronic pancreatitis3 and can alter the natural course of chronic pancreatitis. 4 After the onset of alcohol-related acute pancreatitis, reducing consumption or total abstinence decreases the risk of recurrences. 5 The development of pancreatitis only in a small fraction of alcoholics is likely related to inherent susceptibility. 6, 7 Alcoholics are more likely to be smokers, so there was initial skepticism of the role of smoking in pancreatitis. Smoking is now accepted as an independent risk factor for susceptibility as well as progression of pancreatitis. 8 The effect of smoking is dose-dependent and likely greater in the presence of concomitant alcohol exposure. The relationship between alcohol, smoking, and pancreatitis has been elegantly summarized in previous editorials. 9, 10In a study published in this issue of Pancreas, Setiawan et al11 assessed the relationship between alcohol, smoking, and incident pancreatitis in 145,866 subjects recruited in a multiethnic cohort from 1993-1996. Participants completed a detailed questionnaire at study entry, including questions on their drinking and smoking habits. Information on alcohol exposure was limited to the year before enrollment. Hospitalizations for incident pancreatitis through 2012 (n= 2810) were identified by a variety of record linkages. Pancreatitis events were divided into acute gallstone (37.9%), acute nongallstone (43.5%), and recurrent acute or chronic pancreatitis (18.6%). Subjects were aged between 45 and 75 years at study entry, and the average time from study entry to hospitalization for pancreatitis was 10.1 years.