Dugum Mohannad, Gougol Amir, Paragomi Pedram, Gao Xiaotian, Matta Bassem, Yazici Cemal, Tang Gong, Greer Phil, Pothoulakis Ioannis, O'Keefe Stephen J D, Whitcomb David C, Yadav Dhiraj, Papachristou Georgios I
Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA.
Curr Dev Nutr. 2018 Oct 8;2(12):nzy075. doi: 10.1093/cdn/nzy075. eCollection 2018 Dec.
The effect of diet on risk of acute pancreatitis (AP) has been suggested by prior studies, but the association of dietary habits with severity of AP has not been previously evaluated.
The objective of the study was to assess differences in reported dietary habits in patients with severe AP compared with those with mild or moderate AP.
A prospectively maintained cohort of patients with AP was utilized. A brief questionnaire on dietary habits was implemented. Dietary habits were categorized based on the overall type of diet, fruit/vegetable servings, fat content, dairy consumption, dessert/sweets consumption, and fluid intake. Patients were grouped into mild/moderate and severe AP. Multivariate analysis was used to determine whether dietary habits have an independent association with AP severity.
407 patients with AP were studied. Mean patient age was 51 y, and 202 (50%) were men. 29% of patients were smokers and 46% actively consumed alcohol. 225 patients had mild AP, 103 moderate AP, and 79 developed severe AP. The 3 groups were comparable in race, body mass index, etiology of AP, and comorbidities. Dietary factors were overall comparable between the groups except for diet type: subjects with severe AP had a higher percentage of consuming a meat-rich diet (84%) than patients with mild AP (72%) and moderate AP (67%) ( = 0.04). Based on multivariable logistic regression, the OR of developing severe AP was 2.5 (95% CI: 1.24-5.32, = 0.01) between patients who eat a meat-rich diet and those who consume a vegetable-based diet.
A meat-rich diet is independently associated with the development of persistent organ failure (severe disease) in patients with AP. These findings require further evaluation and could be useful for patient counseling, risk stratification, and disease prevention. This study is registered at clinicaltrials.gov as NCT03075605.
先前的研究提示了饮食对急性胰腺炎（AP）风险的影响，但饮食习惯与AP严重程度之间的关联此前尚未得到评估。
本研究的目的是评估重度AP患者与轻度或中度AP患者在报告的饮食习惯方面的差异。
使用一个前瞻性维护的AP患者队列。实施了一份关于饮食习惯的简短问卷。饮食习惯根据总体饮食类型、水果/蔬菜摄入量、脂肪含量、乳制品消费、甜点/甜食消费和液体摄入量进行分类。患者被分为轻度/中度和重度AP组。采用多变量分析来确定饮食习惯是否与AP严重程度存在独立关联。
对407例AP患者进行了研究。患者平均年龄为51岁，202例（50%）为男性。29%的患者吸烟，46%的患者有饮酒习惯。225例患者为轻度AP，103例为中度AP，79例发展为重度AP。三组在种族、体重指数、AP病因和合并症方面具有可比性。除饮食类型外，各组之间的饮食因素总体上具有可比性：重度AP患者食用富含肉类饮食的比例（84%）高于轻度AP患者（72%）和中度AP患者（67%）（P = 0.04）。基于多变量逻辑回归，食用富含肉类饮食的患者与食用以蔬菜为主饮食的患者相比，发生重度AP的比值比为2.5（95%CI：1.24 - 5.32，P = 0.01）。
富含肉类饮食与AP患者持续性器官衰竭（严重疾病）的发生独立相关。这些发现需要进一步评估，可能有助于患者咨询、风险分层和疾病预防。本研究已在clinicaltrials.gov上注册，注册号为NCT03075605。
