Risk factors of acute pancreatitis: An ethnic difference

2015/03/30

埔里基督教醫院不分科住院醫師

何御彰

Introduction

Increasing incidence rate of acute pancreatitis 4 to 70 per 100,000 population

Pancreas 2014,43:1117-1122

Increases by an annual average of 1 to 5%Pancreas 2012,41:696-702

Risk factor of acute pancreatitis Cigarette smoking in Western countries

Am J Epidemiol 2008,168:932-937

Arch Intern Med 2008,168:649-656

Alcohol drinking in TaiwanPancreas 2014,43:1117-1122

Introduction

Study from Australia Higher rate of alcohol-related acute pancreatitis

Aust J Rural Health 2001,9:134-137

The aim of the study To investigate the differences in risk factors between Taiwanese

aborigines and non-aborigines

Materials and Methods

Participants Recruitment

Puli Christian Hospital (PCH) January, 2006 to December, 2014 International Classification of Diseases 577.0

Exclusion Re-admission Nationality other than Republic of China

Materials and Methods

Demographic characteristics Age / Gender / Body mass index

Social habitus Alcohol drinking / Betel nut chewing / Cigarette smoking

Biochemical properties Amylase / Lipase / Triglyceride / Uric acid / Calcium

Risk factors Alcohol-related / Gallstone / Hypertriglyceridemia Distal CBD obstruction / Hypercalcemia / Unknown

Materials and Methods

Statistical analysis Two tailed unpaired student’s t test

Age / BMI Amylase / Lipase / Triglyceride / Uric acid / Calcium

Pearson’s chi-squared test and Fisher’s exact test Gender Habitus Risk factor of acute pancreatitis

Result

Result

Result

Discussion

Demographic characteristics & Social habitus Aborigines

Younger Higher female-to-male ratio More habitus of alcohol drinking

Major issue of public health in Taiwanese aborigines More readily accessibility to alcohol Stress of marital life

Alcohol Clin Exp Res 1995,19:81-91

Soc Psychiatry Psychiatr Epidemiol 2013,48:955-963

Discussion

Biochemical properties Aborigines

Higher uric acid level Possible explanation

More alcohol consumption More vulnerability of hyperuricemia at a genetic level

Am J Hum Genet 2004,75:498-503

Higher uric acid level in smoking patients with pancreatitisPrzegl Lek 2013,70:809-812

Discussion

Risk factors Aborigines

More alcohol-related acute pancreatitis Culturally adapted intervention

Motivational care planningAust J Rural Health 2009,17:174-182

General practitioners trainingAust J Rural Health 2013,21:72-79

Discussion

Limitation Inadequate information of alcohol drinking Lack of easily medical accessibility Critical condition with immediate referral Extensive risk factor surveys were not conducted for everyone

Conclusion

Taiwanese aborigines are more susceptible to alcohol-related pancreatitis than non-aborigines.

The importance of public health education and effective strategy to prevent them from alcoholism cannot be overemphasized

Thank you for your listening