Alcohol and Smoking as Risk Factors in an Epidemiology Study of Patients With Chronic Pancreatitis

Gregory A. Coté, 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

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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.

Original languageEnglish (US)
Pages (from-to)266-273
Number of pages8
JournalClinical Gastroenterology and Hepatology
Volume9
Issue number3
DOIs
StatePublished - Mar 1 2011

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Keywords

  • Alcoholism
  • Inflammation
  • Pancreas
  • Tobacco

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Coté, G. A., Yadav, D., Slivka, A., Hawes, R. H., Anderson, M. A., Burton, F. R., Brand, R. E., Banks, P. A., Lewis, M. D., Disario, J. A., Gardner, T. B., Gelrud, A., Amann, S. T., Baillie, J., Money, M. E., O'Connell, M., Whitcomb, D. C., & Sherman, S. (2011). Alcohol and Smoking as Risk Factors in an Epidemiology Study of Patients With Chronic Pancreatitis. Clinical Gastroenterology and Hepatology, 9(3), 266-273. https://doi.org/10.1016/j.cgh.2010.10.015