Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK.
Department of Nutrition, Bjørknes University College, Oslo, Norway.
Dig Dis Sci. 2021 Apr;66(4):1249-1267. doi: 10.1007/s10620-020-06275-6. Epub 2020 Jun 19.
Higher body mass index and waist circumference have been associated with increased risk of pancreatitis in several prospective studies; however, the results have not been entirely consistent.
We conducted a systematic review and dose-response meta-analysis of prospective studies on adiposity and risk of pancreatitis to clarify this association.
PubMed and Embase databases were searched for studies on adiposity and pancreatitis up to January 27, 2020. Prospective studies reporting adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for the association between adiposity and risk of pancreatitis were included, and summary RRs (95% CIs) were calculated using a random effects model.
Ten prospective studies with 5129 cases and 1,693,657 participants were included. The summary RR (95% CI) of acute pancreatitis was 1.18 (95% CI: 1.03-1.35, I = 91%, n = 10 studies) per 5 kg/m increase in BMI and 1.36 (95% CI: 1.29-1.43, I = 0%, n = 3) per 10 cm increase in waist circumference. There was evidence of a nonlinear association between BMI and acute pancreatitis, p < 0.0001, with a steeper association at higher levels of BMI, but not for waist circumference, p = 0.19. Comparing a BMI of 35 with a BMI of 22, there was a 58% increase in the RR and there was a fourfold increase in the RR comparing a waist circumference of 110 cm with 69 cm. There was no evidence of publication bias.
This meta-analysis suggests that both increasing BMI and waist circumference are associated with a dose-response-related increase in the risk of acute pancreatitis.
多项前瞻性研究表明,较高的体重指数和腰围与胰腺炎风险增加相关;然而,结果并非完全一致。
我们进行了一项系统综述和剂量-反应荟萃分析,以澄清前瞻性研究中肥胖与胰腺炎风险之间的关系。
截至 2020 年 1 月 27 日,我们在 PubMed 和 Embase 数据库中检索了关于肥胖与胰腺炎的研究。纳入了报告肥胖与胰腺炎风险之间关联的调整后相对风险(RR)估计值和 95%置信区间(CI)的前瞻性研究,并使用随机效应模型计算汇总 RR(95%CI)。
纳入了 10 项前瞻性研究,共纳入 5129 例病例和 1693657 名参与者。BMI 每增加 5kg/m2,急性胰腺炎的汇总 RR(95%CI)为 1.18(95%CI:1.03-1.35,I=91%,n=10 项研究),腰围每增加 10cm,RR 为 1.36(95%CI:1.29-1.43,I=0%,n=3 项研究)。BMI 与急性胰腺炎之间存在非线性关联,p<0.0001,BMI 水平较高时关联更陡峭,但腰围无此关联,p=0.19。与 BMI 为 22 相比,BMI 为 35 时 RR 增加 58%,与腰围 69 相比,腰围 110 时 RR 增加 4 倍。没有发现发表偏倚的证据。
这项荟萃分析表明,BMI 和腰围的增加均与急性胰腺炎风险呈剂量-反应相关的增加相关。