University of Tasmania, Hobart Clinical School, Private Bag 96, Hobart, Tasmania 7001, Australia.
Pancreatology. 2013 Jan-Feb;13(1):33-7. doi: 10.1016/j.pan.2012.12.004. Epub 2012 Dec 20.
BACKGROUND/OBJECTIVES: While alcohol is considered the most common aetiological factor for chronic pancreatitis, the intake of various nutrient and other substances is thought to act as cofactors in the pathogenesis of the disease due to modulation of oxidative stress. This study examined incident cases of acute pancreatitis to determine the dietary and other intakes that characterize those harbouring underlying chronic pancreatitis.
Cases of acute pancreatitis presenting to a single institution were prospectively recruited (n = 153). The presence of chronic pancreatitis was defined by a composite of clinical, biochemical and radiological criteria. Information was obtained on the intake of dietary macro- and micronutrients, coffee, tobacco and alcohol in the period just prior to the acute exacerbation. Univariate and multivariate analyses of association were undertaken. Principal components analysis (PCA) was employed to elicit patterns of intake.
After adjustment for key demographic variables, no individual nutrient or other substance showed a significant association with chronic pancreatitis. However, following PCA there emerged a significant positive association with a so-called "stimulant" intake pattern and a negative association with a so-called "nutritive" pattern.
Preceding an acute exacerbation, patients with underlying chronic pancreatitis are more likely to substitute food-based intake for combinations of other substances, such as tobacco and coffee. This finding may have application in the clinical setting as part of a chronic disease management protocol.
背景/目的:虽然酒精被认为是慢性胰腺炎最常见的病因因素,但由于氧化应激的调节,各种营养物质和其他物质的摄入被认为是疾病发病机制的协同因素。本研究检查了急性胰腺炎的发病病例,以确定那些患有潜在慢性胰腺炎的患者的饮食和其他摄入特征。
前瞻性招募了一家机构就诊的急性胰腺炎病例(n = 153)。慢性胰腺炎的存在通过临床、生化和影像学标准的综合标准来定义。在急性加重之前的时期,获取了关于饮食中宏量和微量营养素、咖啡、烟草和酒精摄入的信息。进行了单变量和多变量关联分析。采用主成分分析(PCA)来得出摄入模式。
在调整了关键人口统计学变量后,没有单个营养素或其他物质与慢性胰腺炎有显著关联。然而,在 PCA 之后,出现了与所谓的“兴奋剂”摄入模式的显著正相关,与所谓的“营养”模式的显著负相关。
在急性加重之前,患有潜在慢性胰腺炎的患者更有可能用烟草和咖啡等其他物质的组合替代基于食物的摄入。这一发现可能在临床环境中作为慢性病管理方案的一部分具有应用价值。