Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy.
Pancreas. 2010 Nov;39(8):1205-10. doi: 10.1097/MPA.0b013e3181df27c0.
To assess the evidence for tobacco smoking as a risk factor for the causation of chronic pancreatitis.
We performed a meta-analysis with random-effects models to estimate pooled relative risks (RRs) of chronic pancreatitis for current, former, and ever smokers, in comparison to never smokers. We also performed dose-response, heterogeneity, publication bias, and sensitivity analyses.
Ten case-control studies and 2 cohort studies that evaluated, overall, 1705 patients with chronic pancreatitis satisfied the inclusion criteria. When contrasted to never smokers, the pooled risk estimates for current smokers was 2.8 (95% confidence interval [CI], 1.8-4.2) overall and 2.5 (95% CI, 1.3-4.6) when data were adjusted for alcohol consumption. A dose-response effect of tobacco use on the risk was ascertained: the RR for subjects smoking less than 1 pack per day was 2.4 (95% CI, 0.9-6.6) and increased to 3.3 (95% CI, 1.4-7.9) in those smoking 1 or more packs per day. The risk diminished significantly after smoking cessation, as the RR estimate for former smokers dropped to a value of 1.4 (95% CI, 1.1-1.9).
Tobacco smoking may enhance the risk of developing chronic pancreatitis. Recommendation for smoking cessation, besides alcohol abstinence, should be incorporated in the management of patients with chronic pancreatitis.
评估吸烟作为慢性胰腺炎病因的风险因素的证据。
我们采用随机效应模型进行荟萃分析，以估计当前、曾经和曾经吸烟者与从不吸烟者相比，慢性胰腺炎的 pooled 相对风险（RR）。我们还进行了剂量反应、异质性、发表偏倚和敏感性分析。
十项病例对照研究和两项队列研究共评估了 1705 名慢性胰腺炎患者，符合纳入标准。与从不吸烟者相比，当前吸烟者的 pooled 风险估计值为 2.8（95%置信区间[CI]，1.8-4.2），当数据调整为酒精消费时为 2.5（95%CI，1.3-4.6）。确定了吸烟与风险之间的剂量反应效应：每天吸烟少于 1 包的受试者的 RR 为 2.4（95%CI，0.9-6.6），而每天吸烟 1 包或更多包的 RR 增加到 3.3（95%CI，1.4-7.9）。停止吸烟后，风险显著降低，因为 former 吸烟者的 RR 估计值降至 1.4（95%CI，1.1-1.9）。
吸烟可能会增加患慢性胰腺炎的风险。除了戒酒之外，建议戒烟应纳入慢性胰腺炎患者的管理中。
