da Costa Marianges Zadrozny Gouvêa, Pires Júlia Glória Lucatelli, Nasser Paulo Dominguez, Ferreira Camila da Silva, Teixeira Ana Cristina de Sá, Paranaguá-Vezozzo Denise Cerqueira, Guarita Dulce Reis, Carrilho Flair José, Ono Suzane Kioko
From the Department of Gastroenterology, University of São Paulo, School of Medicine, São Paulo, Brazil.
Pancreas. 2016 Oct;45(9):1330-5. doi: 10.1097/MPA.0000000000000650.
This study aimed to investigate the association between chronic pancreatitis and smoking or genetic mutations.
The study sample comprised 148 patients with chronic pancreatitis, 110 chronic alcoholic subjects without pancreatic disease, and 297 volunteer blood donors.
Of the patients with chronic pancreatitis, 74% had alcoholic etiology and 26% had idiopathic pancreatitis. The frequency of smoking was 91.4% in patients with alcoholic pancreatitis, higher than 73.3% in alcoholic subjects without pancreatitis (P < 0.01). The difference in smoking frequency was not significant between the patients with idiopathic pancreatitis and blood donors. The N34S mutation of serine peptidase inhibitor, Kazal type 1 (SPINK1) was found in 2.7% of patients with chronic alcoholic pancreatitis, in 5.3% of patients with idiopathic pancreatitis, and in 0.4% of blood donors (P = 0.02). The P55S mutation of SPINK1 was found in 2.7% of patients with alcoholic pancreatitis and in 0.7% of blood donors (P = 0.12). The R254W mutation of chymotrypsin C was found in 0.9% of patients with alcoholic pancreatitis, in 0.9% of chronic alcoholic subjects without pancreatitis, and in 0.4% of blood donors (P = 0.75). In all cases, the mutations were heterozygous.
Smoking and the N34S mutation of SPINK1 were positively correlated with chronic pancreatitis.
本研究旨在调查慢性胰腺炎与吸烟或基因突变之间的关联。
研究样本包括148例慢性胰腺炎患者、110例无胰腺疾病的慢性酒精中毒者以及297名志愿献血者。
在慢性胰腺炎患者中，74%有酒精性病因，26%有特发性胰腺炎。酒精性胰腺炎患者的吸烟率为91.4%，高于无胰腺炎的酒精中毒者的73.3%（P<0.01）。特发性胰腺炎患者与献血者之间的吸烟率差异不显著。在2.7%的慢性酒精性胰腺炎患者、5.3%的特发性胰腺炎患者以及0.4%的献血者中发现了丝氨酸蛋白酶抑制剂Kazal型1（SPINK1）的N34S突变（P = 0.02）。在2.7%的酒精性胰腺炎患者和0.7%的献血者中发现了SPINK1的P55S突变（P = 0.12）。在0.9%的酒精性胰腺炎患者、0.9%的无胰腺炎的慢性酒精中毒者以及0.4%的献血者中发现了糜蛋白酶C的R254W突变（P = 0.75）。在所有病例中，突变均为杂合子。
吸烟和SPINK1的N34S突变与慢性胰腺炎呈正相关。
