Metabolic and lifestyle risk factors for acute pancreatitis in Chinese adults: A prospective cohort study of 0.5 million people
| العنوان: | Metabolic and lifestyle risk factors for acute pancreatitis in Chinese adults: A prospective cohort study of 0.5 million people |
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| المؤلفون: | Michael V. Holmes, Zhengming Chen, Ling Yang, Qinai Xu, Quan Kang, Zheng Bian, Iain Turnbull, Junshi Chen, Yiping Chen, Iona Y Millwood, Yu Guo, Fiona Bragg, Christiana Kartsonaki, Weiwei Gong, Liming Li, Yuanjie Pang |
| المصدر: | PLoS Medicine PLoS Medicine, Vol 15, Iss 8, p e1002618 (2018) |
| بيانات النشر: | Public Library of Science, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, Metabolic equivalent, Cohort Studies, 0302 clinical medicine, Endocrinology, Drug Metabolism, Risk Factors, Medicine and Health Sciences, Public and Occupational Health, Prospective Studies, Prospective cohort study, Alcohol Consumption, Hazard ratio, Smoking, 1. No poverty, Gallbladder, General Medicine, Middle Aged, 3. Good health, Liver, Oncology, 030220 oncology & carcinogenesis, Acute Disease, Medicine, Acute pancreatitis, 030211 gastroenterology & hepatology, Female, Anatomy, Waist Circumference, Cohort study, Research Article, Adult, medicine.medical_specialty, China, Alcohol Drinking, Endocrine Disorders, Gallbladder disease, Gastroenterology and Hepatology, Gallbladder Diseases, 03 medical and health sciences, Pancreatic Cancer, Sex Factors, Internal medicine, Gastrointestinal Tumors, Metabolic Equivalent, medicine, Diabetes Mellitus, Humans, Pharmacokinetics, Obesity, Risk factor, Mortality, Exercise, Life Style, Nutrition, Proportional Hazards Models, Pharmacology, business.industry, Biology and Life Sciences, Health Risk Analysis, Cancers and Neoplasms, Physical Activity, medicine.disease, Diet, Health Care, Pancreatic Neoplasms, Pancreatitis, Metabolic Disorders, Biliary System, business |
| الوصف: | Background Little prospective evidence exists about risk factors and prognosis of acute pancreatitis in China. We examined the associations of certain metabolic and lifestyle factors with risk of acute pancreatitis in Chinese adults. Methods and findings The prospective China Kadoorie Biobank (CKB) recruited 512,891 adults aged 30 to 79 years from 5 urban and 5 rural areas between 25 June 2004 and 15 July 2008. During 9.2 years of follow-up (to 1 January 2015), 1,079 cases of acute pancreatitis were recorded. Cox regression was used to estimate adjusted hazard ratios (HRs) for acute pancreatitis associated with various metabolic and lifestyle factors among all or male (for smoking and alcohol drinking) participants. Overall, the mean waist circumference (WC) was 82.1 cm (SD 9.8) cm in men and 79.0 cm (SD 9.5) cm in women, 6% had diabetes, and 6% had gallbladder disease at baseline. WC was positively associated with risk of acute pancreatitis, with an adjusted HR of 1.35 (95% CI 1.27–1.43; p < 0.001) per 1-SD-higher WC. Individuals with diabetes or gallbladder disease had HRs of 1.34 (1.07–1.69; p = 0.01) and 2.42 (2.03–2.88; p < 0.001), respectively. Physical activity was inversely associated with risk of acute pancreatitis, with each 4 metabolic equivalent of task (MET) hours per day (MET-h/day) higher physical activity associated with an adjusted HR of 0.95 (0.91–0.99; p = 0.03). Compared with those without any metabolic risk factors (i.e., obesity, diabetes, gallbladder disease, and physical inactivity), the HRs of acute pancreatitis for those with 1, 2, or ≥3 risk factors were 1.61 (1.47–1.76), 2.36 (2.01–2.78), and 3.41 (2.46–4.72), respectively (p < 0.001). Among men, heavy alcohol drinkers (≥420 g/week) had an HR of 1.52 (1.11–2.09; p = 0.04, compared with abstainers), and current regular smokers had an HR of 1.45 (1.28–1.64; p = 0.02, compared with never smokers). Following a diagnosis of acute pancreatitis, there were higher risks of pancreatic cancer (HR = 8.26 [3.42–19.98]; p < 0.001; 13 pancreatic cancer cases) and death (1.53 [1.17–2.01]; p = 0.002; 89 deaths). Other diseases of the pancreas had similar risk factor profiles and prognosis to acute pancreatitis. The main study limitations are ascertainment of pancreatitis using hospital records and residual confounding. Conclusions In this relatively lean Chinese population, several modifiable metabolic and lifestyle factors were associated with higher risks of acute pancreatitis, and individuals with acute pancreatitis had higher risks of pancreatic cancer and death. In a prospective cohort study including 0.5 million Chinese adults, Yuanjie Pang and colleagues investigate whether factors such as adiposity, diabetes, drinking, smoking, and physical activity are associated with risk of acute pancreatitis. Author summary Why was this study done? Smoking, alcohol, and gallbladder disease are risk factors for acute pancreatitis in Western populations. The relevance of certain lifestyle and metabolic factors (e.g., adiposity, diabetes, and physical activity) for acute pancreatitis has not been properly investigated in East Asian populations. In China, there is limited prospective evidence on risk factors for acute pancreatitis. What did the researchers do and find? A total of 512,891 Chinese adults were recruited from 5 urban and 5 rural areas across China in 2004–2008; participants completed a detailed questionnaire interview and underwent physical measurements and blood tests, and we then tracked their health until 1 January 2015 (median 9.2 years). Individuals with diabetes, gallbladder disease, or higher levels of adiposity were at a significantly higher risk of developing acute pancreatitis, while those with higher levels of physical activity had a lower risk of acute pancreatitis. Among men, smoking and heavy alcohol drinking were important risk factors for acute pancreatitis. Participants with acute pancreatitis were at higher risk of death and developing pancreatic cancer. What do these findings mean? To our knowledge, this is the first prospective study investigating lifestyle and metabolic risk factors for acute pancreatitis in the Chinese population. The modifiable nature of the risk factors suggests that, assuming cause and effect, many cases of acute pancreatitis in Chinese individuals might be prevented with modifications to lifestyle. The strong link between acute pancreatitis and pancreatic cancer, as well as their shared risk factors (i.e., smoking, heavy drinking, adiposity, diabetes), suggests that acute pancreatitis and pancreatic cancer may share similar aetiologies. |
| اللغة: | English |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7bbe3787efa5baf90c18f02fb4e07742Test https://ora.ox.ac.uk/objects/uuid:24384cc0-4cab-482a-a60d-967dc1884aebTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....7bbe3787efa5baf90c18f02fb4e07742 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |