Zhu G L, Chen S H, Fan X D, Fan J C, Men X L, Zhang Y M, Sun Q, Zhang B, Ji R G, Wang S, Tong B, Zhang J, Wu S L, Jiang X Z
Department of Gastroenterology, Kailuan General Hospital, Tangshan 063000, China.
Healthcare Center of Kailuan Group, Tangshan 063000, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Dec 10;42(12):2131-2137. doi: 10.3760/cma.j.cn112338-20201027-01286.
To investigate the effects of body mass index (BMI) levels at different baseline on the risk of new-onset acute pancreatitis (AP). The subjects were from the Kailuan Study Cohort and divided into 3 groups according to baseline BMI levels: BMI<24 kg/m, normal weight; BMI 24-28 kg/m, overweight; BMI≥28 kg/m, obesity. The incidence of new-onset AP in these three groups was analyzed. The survival curve was plotted by Kaplan-Meier method, the cumulative incidence was calculated and tested by log-rank method. Multivariate Cox proportional hazards regression model was used to calculate of baseline BMI levels for AP. A total of 123 841 subjects were included and followed up for (11.94±2.13) years, during which, 395 cases were found with AP. The incidence of AP was 2.67 per 10 000 person years in total population, and the incidences of AP were 2.20, 2.72 and 3.58 per 10 000 person-years in the normal, overweight and obesity groups, respectively. The cumulative incidences of AP was 0.32%, 0.40% and 0.49% in normal, overweight and obesity groups, respectively, which showed a significant inter-group difference by log-rank test ( =13.17,<0.01). The results of multivariable adjusted Cox proportional hazards regression model analysis indicated that obesity group (=1.45, 95%: 1.10-1.92) had a higher risk for AP compared with the normal BMI group. The subgroup analyses by age and sex showed that compared with the normal weight group,the s for AP in the obesity group was 1.58(95%:1.14-2.19) and 1.40(95%:1.03-1.90) among subjects younger than 60 years old and male subjects, respectively. After excluded onset AP within two years from baseline,with a control group from normal weight,the results of multivariate Cox proportional hazards regression model analysis indicated that the AP in the obesity group was 1.60 (95%: 1.18-2.15). Obesity may increase the risk of developing AP, particularly among young and middle-aged men.
为探讨不同基线体重指数(BMI)水平对新发急性胰腺炎(AP)风险的影响。研究对象来自开滦研究队列,根据基线BMI水平分为3组:BMI<24kg/m²,正常体重;BMI 24 - 28kg/m²,超重;BMI≥28kg/m²,肥胖。分析这三组中新发AP的发生率。采用Kaplan-Meier法绘制生存曲线,计算累积发病率并用对数秩检验进行检验。使用多变量Cox比例风险回归模型计算基线BMI水平对AP的影响。共纳入123841名研究对象,随访(11.94±2.13)年,期间发现395例AP病例。总体人群中AP的发病率为每10000人年2.67例,正常、超重和肥胖组中AP的发病率分别为每10000人年2.20例、2.72例和3.58例。正常、超重和肥胖组中AP的累积发病率分别为0.32%、0.40%和0.49%,经对数秩检验显示组间差异有统计学意义(χ² = 13.17,P<0.01)。多变量校正Cox比例风险回归模型分析结果表明,肥胖组(HR = 1.45,95%CI:1.10 - 1.92)与正常BMI组相比,发生AP的风险更高。按年龄和性别进行的亚组分析显示,与正常体重组相比,60岁以下人群和男性中肥胖组发生AP的HR分别为1.58(95%CI:1.14 - 2.19)和1.40(95%CI:1.03 - 1.90)。从基线起排除两年内发病的AP病例,以正常体重组作为对照组,多变量Cox比例风险回归模型分析结果表明,肥胖组发生AP的HR为1.60(95%CI:1.18 - 2.15)。肥胖可能增加发生AP的风险,尤其是在中青年男性中。