首页|长期饮酒人群发生急性胰腺炎的风险因素分析:一项基于UK Biobank的自然人群研究

长期饮酒人群发生急性胰腺炎的风险因素分析:一项基于UK Biobank的自然人群研究

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目的 探讨有长期饮酒习惯人群急性胰腺炎(acute pancreatitis,AP)发生的风险因素.方法 将由UK Biobank数据库中筛选的初次参与调查(2006年—2010年)和第二次随访(2014+)均为"目前饮酒状态"的志愿者作为目标人群(观察至2022年11月30日,期间新诊断AP 176人,未患AP 59 512人).收集目标人群入组时的手术史、饮食习惯等,并通过多因素Cox比例风险模型探讨其是否为AP发生的风险因素.同时以目标人群中有"饮酒类型"记录的人群为亚组,通过多因素Cox比例风险模型探讨不同酒类摄入量及增长量是否为AP发生的风险因素.结果 多因素分析结果显示,每天摄入熟菜1~4汤匙,患AP风险分别为不摄入熟菜的44%(HR=0.44,95%CI:0.20~0.95)、39%(HR=0.39,95%CI:0.19~0.82)、42%(HR=0.42,95%CI:0.20~0.89)和 41%(HR=0.41,95%CI:0.19~0.88);每天摄入2和3杯咖啡患AP风险为不摄入咖啡人群的45%(HR=0.45,95%CI:0.27~0.75)和39%(HR=0.39,95%CI:0.21~0.72);有胆源性疾病(BD)但未行胆囊切除术(CHO)患AP风险为无BD且未行CHO的7.82倍(HR=7.82,95%CI:5.30~11.54),有BD且行CHO患AP的风险仅为无BD且未行CHO的2.15倍(HR=2.15,95%CI:1.15~4.01).亚组分析结果显示,不同酒类的摄入量均不影响AP的发生,但在此基础上纳入不同酒类摄入增长量后的结果表明,烈酒摄入增长量每升高1瓶/周、患AP的风险增长1.05倍(HR=1.05,95%CI:1.02~1.09,P<0.05).结论 在有长期饮酒习惯的人群中,熟菜和适量的咖啡摄入是AP发生的保护因素;患BD且不切除胆囊为AP发生的危险因素,而患BD且进行CHO 人群的AP发生显著降低;烈酒摄入增长量上升也是AP发生的危险因素.
Risk factors for acute pancreatitis in long-term drinking participants:a longitudinal UK Biobank-based study
Objective To examine risk factors for acute pancreatitis(AP)in individuals with chronic alcohol consumption habits.Methods The study incorporated participants from the initial survey(2006-2010)and subsequent follow-ups(2014+)taken from the UK Biobank database,with the observation period ending on November 30,2022.During this period,176 individuals were newly diagnosed with AP,while 59,512 remained unaffected.Vital characteristics of the target population,such as their medical histories,surgical experiences and dietary patterns,were collected during the enrolment phase(2006-2010).The Cox proportional hazard model was employed to ascertain whether these characteristics were potent risk factors for AP.Concurrently,a subgroup from the target population with documented drinking behavior was selected.The multivariate Cox proportional hazard model was utilized to analyze the relationship of the established factors,variances in alcohol consumption,and increased alcohol intake(△)with the onset of AP,and whether the additional alcohol intake served as a risk factor.Results Multivariate analysis revealed that consumption quantity of cooked vegetables inversely correlated with AP risk(HR=0.44,0.39,0.42 and 0.41 for one,two,three and four+tablespoons per day,respectively,as compared to non-consumers).Coffee consumption(2-3 cups per day)also reduced AP risk(HR=0.45 for 2 cups/day;HR=0.39 for 3 cups/day as compared to non-coffee drinkers).However,those with biliary disease without cholecystectomy exhibited a marked increase in AP risk(HR=7.82),which reduced albeit remained elevated for those with biliary disease post-cholecystectomy(HR=2.15).Subgroup analysis showed minimal impact of alcohol intake levels on AP incidence.Yet,increased alcohol consumption(△ of 1 bottle/week)was linked to a heightened AP risk(HR=1.05,95%CI:1.02-1.09,P<0.05).Conclusion Among longstanding alcohol consumers,a diet rich in cooked vegetables and moderate coffee consumption offers protective effects against AP.Conversely,biliary disease(particularly without cholecystectomy)and elevated alcohol intake present considerable risk factors for the development of this condition.

acute pancreatitis(AP)UK Biobank databaselong-term drinking habitrisk factor

赵锦鹏、马翼飞、马清涌、仵正、王铮、杨雪

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西安交通大学第一附属医院肝胆外科,陕西西安 710061

西安交通大学胰腺疾病诊疗中心,陕西西安 710061

急性胰腺炎(AP) UK Biobank数据库 长期饮酒习惯 风险因素

国家自然科学基金青年基金

82072702

2024

西安交通大学学报(医学版)
西安交通大学

西安交通大学学报(医学版)

CSTPCD北大核心
影响因子:1.144
ISSN:1671-8259
年,卷(期):2024.45(2)
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