■大量饮酒和遗传因素代表了慢性胰腺炎(CP)的2种主要病因。然而,到目前为止,对轻度至中度饮酒相关CP(LMA-CP)的临床特征和遗传基础知之甚少。
■对2010年至2015年的1061例中国CP患者进行了横断面分析。CP被归类为经典酒精CP(ACP;n=206),LMA-CP(n=154),和特发性CP(ICP;n=701)。临床特征和遗传特征(PRSS1,SPINK1,CTRC,比较不同组之间的CFTR变体状态)。计算具有95%置信区间的赔率比(OR),以确定饮酒和基因突变的组合效应。
■与ICP相比,LMA-CP的临床特征是胰腺结石的发生率较高,假性囊肿,糖尿病,和脂肪泻,与ACP相关。LMA-CP中CP相关基因变异的患病率为38.3%,与ACP相似(39.8%),虽然明显低于ICP(56.2%)。饮酒增加了不良临床结果的风险,而遗传因素放大了酒精的影响。与ICP相比,LMA-CP和ACP与胰腺结石的高风险相关(无变异的患者,OR=2.01和2.54;有变异的患者,OR=2.17和1.07),假性囊肿(无变异的患者,OR=1.03和1.43;有变异的患者,OR=1.67和2.14),糖尿病(没有变异的患者,OR=0.86和1.31;有变异的患者,OR=2.05和1.55),和脂肪泻(没有变异的患者,OR=1.56和2.10;有变异的患者,OR=2.11和1.60)。
■有证据表明LMA-CP在临床和遗传上与ACP相似,但与ICP有显著差异。我们的发现为越来越多的人认为没有安全的饮酒水平提供了支持。
UNASSIGNED: Heavy alcohol consumption and genetic factors represent the 2 major etiologies of chronic pancreatitis (CP). However, little is so far known about the clinical features and genetic basis of light-to-moderate alcohol consumption-related CP (LMA-CP).
UNASSIGNED: A cross-sectional analysis was performed on 1061 Chinese CP patients between 2010 and 2015. CP was classified as classical alcoholic CP (ACP; n = 206), LMA-CP (n = 154), and idiopathic CP (ICP; n = 701). Clinical features and genetic characteristics (PRSS1, SPINK1, CTRC, CFTR variant status) were compared between the different groups. Odds ratios (ORs) with 95% confidence intervals were calculated to ascertain the combinatorial effect of alcohol consumption and gene mutation.
UNASSIGNED: Compared with ICP, the clinical features of LMA-CP were characterized by higher rates of developing pancreatic stones, pseudocyst, diabetes, and steatorrhea, which were similar to those associated with ACP. The prevalence of CP-related gene variants in LMA-CP was 38.3%, similar to ACP (39.8%), although significantly lower than ICP (56.2%). Alcohol consumption enhanced the risk of a poor clinical outcome, whereas genetic factors amplified alcohol\'s effects. Compared with ICP, LMA-CP and ACP were associated with a high risk of pancreatic stones (patients without variants, OR = 2.01 and 2.54; patients with variants, OR = 2.17 and 1.07), pseudocyst (patients without variants, OR = 1.03 and 1.43; patients with variants, OR = 1.67 and 2.14), diabetes mellitus (patients without variants, OR = 0.86 and 1.31; patients with variants, OR = 2.05 and 1.55), and steatorrhea (patients without variants, OR = 1.56 and 2.10; patients with variants, OR = 2.11 and 1.60).
UNASSIGNED: Evidence was presented to show that LMA-CP was clinically and genetically similar to ACP but significantly different from ICP. Our findings provide support to the growing view that there is no safe level of alcohol consumption.