A prospective cohort study of smoking in acute pancreatitis.
OBJECTIVE
Little is known about risk factors for acute pancreatitis other than gallstones and alcohol consumption. The aim of this study was to investigate if smoking or body mass index (BMI) are associated with acute pancreatitis and to determine relative risks (RR) for acute pancreatitis related to smoking, BMI, and alcohol consumption.


METHODS
From 1974 to 1992, selected birth-year cohorts of residents in Malmo, Sweden (born 1921-1949) were invited to a health-screening investigation including physical examination, blood sampling and a questionnaire. In total, 33,346 individuals participated. Cases of acute pancreatitis were identified from diagnosis registries (n = 179). Incidence rates were calculated in different risk factor categories. A Cox's analysis revealed RR.


RESULTS
Current versus never smoking at baseline was associated with acute pancreatitis (RR 2.14, 95% confidence interval (CI) 1.48-3.09) after adjustment for age, sex, BMI and alcohol consumption. This association was stronger in heavy smokers (20-30 cigarettes/day) (RR 3.19, 95% CI 2.03-5.00). Smoking was associated with a RR of 3.57 (95% CI 0.98-13.0) for acute pancreatitis in subjects who reported no alcohol consumption. An increased risk for acute pancreatitis was also found for high versus low risk, self-reported alcohol consumption (RR 2.55, 95% CI 1.59-4.08) and for gamma-GT levels in the highest versus the lowest quartile (RR 2.14, 95% CI 1.32-3.49). There was also a weak correlation between BMI and acute pancreatitis.


CONCLUSIONS
Smoking is associated with the incidence of acute pancreatitis in a dose-response manner. and IAP.
Lindkvist
Bjorn
B
Department of Clinical Sciences, Malmo University Hospital, Lund University, Malmo, Sweden. bjorn.lindkvist@med.lu.se
Appelros
Stefan
S
Manjer
Jonas
J
Berglund
Goran
G
Borgstrom
Anders
A
D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D010195:Pancreatitis / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013548:Sweden; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase