Suazo-Baráhona J, Carmona-Sánchez R, Robles-Díaz G, Milke-García P, Vargas-Vorácková F, Uscanga-Domínguez L, Peláez-Luna M
Department of Gastroenterology, Instituto Nacional de la Nutrición Salvador Zubirán, México City, México.
Am J Gastroenterol. 1998 Aug;93(8):1324-8. doi: 10.1111/j.1572-0241.1998.442_l.x.
In this study we evaluate the association between obesity and complication development in patients with a first-attack acute pancreatitis (AP), and investigate the influence of comorbid factors on this association.
Medical records of 150 patients with AP were reviewed. General data, AP etiology, admission AP prognostic criteria, and occurrence of complications were recorded. Patients were classified according to body mass index (BMI) as obese (BMI > 25 kg/m2) and nonobese (BMI < or = 25 kg/m2).
Prevalence of obesity was 57%. Thirty-eight percent of the obese patients developed complications as compared with 21% of the nonobese (RR=1.74; 95% CI, 1-2.9). The risk for severe AP increased according to the degree of obesity. Pancreatic and peripancreatic necrosis was more common in obese patients (17.6% vs 6%), as was the incidence of infectious complications. The risk for severe AP was highest in obese patients with either alcoholic (RR=5.3; 95% CI, 1.2-23) or biliary etiology (RR=5.2, 95% CI, 1-26).
Obesity may predispose to a complicated course of AP, especially if it is secondary to alcohol or gallstones. Further studies are needed to establish the precise prognostic value of obesity in AP, as well as the pathogenic mechanisms involved in the process.
在本研究中，我们评估首次发作的急性胰腺炎（AP）患者肥胖与并发症发生之间的关联，并研究合并因素对这种关联的影响。
回顾了150例AP患者的病历。记录一般资料、AP病因、入院时AP预后标准及并发症发生情况。根据体重指数（BMI）将患者分为肥胖组（BMI>25kg/m²）和非肥胖组（BMI≤25kg/m²）。
肥胖患病率为57%。肥胖患者中有38%发生了并发症，而非肥胖患者为21%（相对危险度=1.74；95%可信区间，1 - 2.9）。严重AP的风险随着肥胖程度的增加而升高。胰腺及胰周坏死在肥胖患者中更常见（17.6%对6%），感染性并发症的发生率也是如此。酒精性（相对危险度=5.3；95%可信区间，1.2 - 23）或胆源性病因（相对危险度=5.2，95%可信区间，1 - 26）的肥胖患者发生严重AP的风险最高。
肥胖可能易导致AP病情复杂，尤其是继发于酒精或胆结石时。需要进一步研究以确定肥胖在AP中的精确预后价值以及该过程中涉及的致病机制。
