Schulze Center for Novel Therapeutics, Division of Oncology Research, Department of Medicine, Mayo Clinic, Rochester, MA 55905, USA.
World J Gastroenterol. 2013 Feb 7;19(5):638-47. doi: 10.3748/wjg.v19.i5.638.
Although the association between alcohol and pancreatic diseases has been recognized for a long time, the impact of alcohol consumption on pancreatitis and pancreatic cancer (PC) remains poorly defined. Nowadays there is not consensus about the epidemiology and the beverage type, dose and duration of alcohol consumption causing these diseases. The objective of this study was to review the epidemiology described in the literature for pancreatic diseases as a consequence of alcoholic behavior trying to understand the association between dose, type and frequency of alcohol consumption and risk of pancreatitis and PC. The majority of the studies conclude that high alcohol intake was associated with a higher risk of pancreatitis (around 2.5%-3% between heavy drinkers and 1.3% between non drinkers). About 70% of pancreatitis are due to chronic heavy alcohol consumption. Although this incidence rate differs between countries, it is clear that the risk of developing pancreatitis increases with increasing doses of alcohol and the average of alcohol consumption vary since 80 to 150 g/d for 10-15 years. With regard to PC, the role of alcohol consumption remains less clear, and low to moderate alcohol consumption do not appear to be associated with PC risk, and only chronic heavy drinking increase the risk compared with lightly drinkers. In a population of 10%-15% of heavy drinkers, 2%-5% of all PC cases could be attributed to alcohol consumption. However, as only a minority (less than 10% for pancreatitis and 5% for PC) of heavily drinkers develops these pancreatic diseases, there are other predisposing factors besides alcohol involved. Genetic variability and environmental exposures such as smoking and diet modify the risk and should be considered for further investigations.
尽管长期以来人们已经认识到酒精与胰腺疾病之间存在关联，但酒精摄入对胰腺炎和胰腺癌（PC）的影响仍未得到明确界定。目前，关于导致这些疾病的酒精摄入量、类型、剂量和持续时间的流行病学和饮料类型尚未达成共识。本研究的目的是综述文献中描述的与酒精行为有关的胰腺疾病的流行病学，试图了解酒精摄入量、类型和频率与胰腺炎和 PC 风险之间的关联。大多数研究的结论是，大量饮酒与胰腺炎的风险增加有关（重度饮酒者的风险约为 2.5%-3%，非饮酒者的风险约为 1.3%）。大约 70%的胰腺炎是由于慢性大量饮酒引起的。尽管这种发病率在不同国家有所不同，但很明显，随着酒精剂量的增加，胰腺炎的风险会增加，而且由于 10-15 年的平均酒精摄入量在 80 至 150 克/天之间，因此风险也有所不同。至于 PC，酒精摄入的作用仍不明确，低至中度饮酒似乎与 PC 风险无关，只有慢性大量饮酒与轻度饮酒者相比才会增加风险。在 10%-15%的重度饮酒者中，可能有 2%-5%的所有 PC 病例归因于酒精摄入。然而，由于只有少数（胰腺炎少于 10%，PC 少于 5%）重度饮酒者会出现这些胰腺疾病，因此除了酒精之外，还有其他易感因素。遗传变异性和环境暴露，如吸烟和饮食，会改变风险，应该进一步研究。
