Multicenter survey of the etiology of pancreatic diseases. Relationship between the relative risk of developing chronic pancreaitis and alcohol, protein and lipid consumption.

The relationship between the average daily intake of alcohol and the risk of developing chronic pancreatitis was studied in two surveys, one in Marseille (France), the other in 9 centers, in Caucasian-populated countries. In the latter survey, the interactions between alcohol, protein and fat consumption and the risk of chronic pancreatitis have also been statistically analyzed. These studies were performed with hierarchical log-linear models for contingency tables, the relative odds being taken as an approximation of the relative risk. It has been shown that there is no apparent threshold of toxicity of alcohol on the human pancreas. The logarithm of the relative risk of chronic pancreatitis increases linearly as a function of the quantity of alcohol and protein consumed, and varies quadratically as a function of average daily lipid intake (a low- or high-lipid diet increases the risk of developing chronic pancreatitis in comparison to an average-fat diet (85--110 g fat per day). The effects on log-relative risk of alcohol, fat and protein daily consumption are additive. In Marseille, the average duration of alcohol consumption before the appearance of symptoms is 18 +/- 11 years for males and 11 +/- 8 years for females, which is much shorter than the duration of alcohol consumption before onset of symptoms in cirrhotic patients.