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. 2011 Mar;9(3):266-73; quiz e27.
doi: 10.1016/j.cgh.2010.10.015. Epub 2010 Oct 26.

Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis

Gregory A Coté  1 , Dhiraj Yadav, Adam Slivka, Robert H Hawes, Michelle A Anderson, Frank R Burton, Randall E Brand, Peter A Banks, Michele D Lewis, James A Disario, Timothy B Gardner, Andres Gelrud, Stephen T Amann, John Baillie, Mary E Money, Michael O'Connell, David C Whitcomb, Stuart Sherman; North American Pancreatitis Study Group
Affiliations

Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis

Gregory A Coté et al. Clin Gastroenterol Hepatol. 2011 Mar.

Abstract

Background & aims: Alcohol has been implicated in the development of chronic pancreatitis (CP) in 60%-90% of patients, although percentages in the United States are unknown. We investigated the epidemiology of alcohol-related CP at tertiary US referral centers.

Methods: We studied data from CP patients (n = 539) and controls (n = 695) enrolled in the North American Pancreatitis Study-2 from 2000 to 2006 at 20 US referral centers. CP was defined by definitive evidence from imaging or histologic analyses. Subjects and physicians each completed a study questionnaire. Using physician-assigned diagnoses, patients were assigned to an etiology group: alcohol (with/without other diagnoses), nonalcohol (any etiology of CP from other than alcohol), or idiopathic (no etiology identified).

Results: The distribution of patients among etiology groups was: alcohol (44.5%), nonalcohol (26.9%), and idiopathic (28.6%). Physicians identified alcohol as the etiology more frequently in men (59.4% men vs 28.1% women), but nonalcohol (18% men vs 36.7% women) and idiopathic etiologies (22.6% men vs 35.2% women) more often in women (P < .01 for all comparisons). Nonalcohol etiologies were equally divided among obstructive, genetic, and other causes. Compared with controls, patients with idiopathic CP were more likely to have ever smoked (58.6% vs 49.7%, P < .05) or have a history of chronic renal disease or failure (5.2% vs 1.2%, P < .01). In multivariate analyses, smoking (ever, current, and amount) was independently associated with idiopathic CP.

Conclusions: The frequency of alcohol-related CP at tertiary US referral centers is lower than expected. Idiopathic CP and nonalcohol etiologies represent a large subgroup, particularly among women. Smoking is an independent risk factor for idiopathic CP.

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Figures

Figure 1
Figure 1. Distribution of etiologic groups in chronic pancreatitis patients enrolled at different participating centers in the North American Pancreatitis Study 2
Data restricted to NAPS2 medical centers that recruited 25 or more patients. MUSC = Medical University of South Carolina SLU = Saint Louis University
See this image and copyright information in PMC

Comment in

  • Defining the role of smoking in chronic pancreatitis.
    Lowenfels AB, Maisonneuve P. Lowenfels AB, et al. Clin Gastroenterol Hepatol. 2011 Mar;9(3):196-7. doi: 10.1016/j.cgh.2010.11.036. Epub 2010 Dec 8. Clin Gastroenterol Hepatol. 2011. PMID: 21145423 No abstract available.

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