Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Clin Gastroenterol Hepatol. 2014 Apr;12(4):676-82. doi: 10.1016/j.cgh.2013.09.058. Epub 2013 Oct 5.
BACKGROUND & AIMS: Obesity and type 2 diabetes--diseases linked to glucose intolerance and insulin resistance--have been positively associated with the risk of acute pancreatitis. However, it is unclear whether consumption of foods that increase postprandial glycemia and insulinemia have similar associations. We examined the association between dietary glycemic load and risk of non-gallstone-related acute pancreatitis.
We performed a prospective study of 44,791 men and 36,309 women (aged 45-84 years), without a history of acute pancreatitis, from the Cohort of Swedish Men and the Swedish Mammography Cohort. Glycemic loads were calculated from food frequency questionnaire data collected in 1997, and participants were followed for the development of non-gallstone-related acute pancreatitis through 2010 via linkage to the Swedish National Patient Register. Hazard ratios (HRs) were estimated using Cox proportional hazard models.
During a total follow-up of 967,568 person-years, there were 364 cases of incident non-gallstone-related acute pancreatitis (236 in men and 128 in women). Incidence rates, standardized for age and sex, were 49 cases per 100,000 person-years in the highest quartile of glycemic load and 33 cases per 100,000 person-years in the lowest. The multivariate-adjusted HR of non-gallstone-related acute pancreatitis was 1.60 (95% confidence interval [CI], 1.17-2.18) for the highest compared with the lowest quartile. Every 50-unit increase in glycemic load per day (∼ 3 servings of white bread) had an HR of 1.38 in men (95% CI, 1.11-1.72) and women (95% CI, 1.02-1.86).
Based on a large, prospective cohort study, diets with high glycemic load are associated with an increased risk of non-gallstone-related acute pancreatitis.
肥胖症和 2 型糖尿病——与葡萄糖耐量受损和胰岛素抵抗相关的疾病——与急性胰腺炎的风险呈正相关。然而，目前尚不清楚增加餐后血糖和胰岛素水平的食物摄入是否具有相似的关联。我们研究了饮食血糖负荷与非胆石性急性胰腺炎风险之间的关系。
我们对来自瑞典男性队列和瑞典乳腺 X 线摄影队列的 44791 名男性和 36309 名女性（年龄 45-84 岁）进行了一项前瞻性研究，这些参与者均无急性胰腺炎病史。血糖负荷是根据 1997 年收集的食物频率问卷数据计算得出的，通过与瑞典国家患者登记处的关联，对参与者进行随访以确定是否发生非胆石性急性胰腺炎。使用 Cox 比例风险模型估计危险比（HR）。
在总共 967568 人年的随访期间，发生了 364 例非胆石性急性胰腺炎（236 例男性，128 例女性）。经年龄和性别标准化后，血糖负荷最高四分位数的发病率为每 100000 人年 49 例，最低四分位数的发病率为每 100000 人年 33 例。与最低四分位数相比，血糖负荷最高四分位数的非胆石性急性胰腺炎的多变量调整 HR 为 1.60（95%置信区间[CI]，1.17-2.18）。与最低四分位数相比，每天增加 50 个单位的血糖负荷（约 3 份白面包），男性的 HR 为 1.38（95%CI，1.11-1.72），女性的 HR 为 1.38（95%CI，1.02-1.86）。
基于一项大型前瞻性队列研究，高血糖负荷的饮食与非胆石性急性胰腺炎的风险增加相关。
