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

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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  • Authors+Show Affiliations

    ,

    Department of Medicine, Division of Gastroenterology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. gcote@iupui.edu

    , , , , , , , , , , , , , , , , ,

    Source

    MeSH

    Adult
    Aged
    Alcohol Drinking
    Case-Control Studies
    Female
    Humans
    Male
    Middle Aged
    Pancreatitis, Chronic
    Risk Factors
    Smoking
    Surveys and Questionnaires
    United States

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    21029787

    Citation

    Coté, Gregory A., et al. "Alcohol and Smoking as Risk Factors in an Epidemiology Study of Patients With Chronic Pancreatitis." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 9, no. 3, 2011, pp. 266-73; quiz e27.
    Coté GA, Yadav D, Slivka A, et al. Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis. Clin Gastroenterol Hepatol. 2011;9(3):266-73; quiz e27.
    Coté, G. A., Yadav, D., Slivka, A., Hawes, R. H., Anderson, M. A., Burton, F. R., ... Sherman, S. (2011). Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 9(3), pp. 266-73; quiz e27. doi:10.1016/j.cgh.2010.10.015.
    Coté GA, et al. Alcohol and Smoking as Risk Factors in an Epidemiology Study of Patients With Chronic Pancreatitis. Clin Gastroenterol Hepatol. 2011;9(3):266-73; quiz e27. PubMed PMID: 21029787.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis. AU - Coté,Gregory A, AU - Yadav,Dhiraj, AU - Slivka,Adam, AU - Hawes,Robert H, AU - Anderson,Michelle A, AU - Burton,Frank R, AU - Brand,Randall E, AU - Banks,Peter A, AU - Lewis,Michele D, AU - Disario,James A, AU - Gardner,Timothy B, AU - Gelrud,Andres, AU - Amann,Stephen T, AU - Baillie,John, AU - Money,Mary E, AU - O'Connell,Michael, AU - Whitcomb,David C, AU - Sherman,Stuart, AU - ,, Y1 - 2010/10/26/ PY - 2010/08/06/received PY - 2010/09/13/revised PY - 2010/10/01/accepted PY - 2010/10/30/entrez PY - 2010/10/30/pubmed PY - 2011/6/1/medline SP - 266-73; quiz e27 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 9 IS - 3 N2 - 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. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/21029787/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(10)01028-1 DB - PRIME DP - Unbound Medicine ER -