High Clinical and Genetic Similarity Between Chronic Pancreatitis Associated With Light-to-Moderate Alcohol Consumption and Classical Alcoholic Chronic Pancreatitis

Yuan-Chen Wang; Wen-Bin Zou; Da-Hai Tang; Lei Wang; Liang-Hao Hu; Yang-Yang Qian; David N. Cooper; Claude Férec; Zhao-Shen Li; Jian-Min Chen; Zhuan Liao

Gastro Hep Advances (Jan 2023)

High Clinical and Genetic Similarity Between Chronic Pancreatitis Associated With Light-to-Moderate Alcohol Consumption and Classical Alcoholic Chronic Pancreatitis

Yuan-Chen Wang,
Wen-Bin Zou,
Da-Hai Tang,
Lei Wang,
Liang-Hao Hu,
Yang-Yang Qian,
David N. Cooper,
Claude Férec,
Zhao-Shen Li,
Jian-Min Chen,
Zhuan Liao

Affiliations

Yuan-Chen Wang: Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Digestive Endoscopy Center, Changhai Hospital, Naval Medical University, Shanghai, China; Shanghai Institute of Pancreatic Diseases, Shanghai, China
Wen-Bin Zou: Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Digestive Endoscopy Center, Changhai Hospital, Naval Medical University, Shanghai, China; Shanghai Institute of Pancreatic Diseases, Shanghai, China; Wen-Bin Zou, MD, Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China.
Da-Hai Tang: Department of Laboratory Diagnostics, Changhai Hospital, Naval Medical University, Shanghai, China
Lei Wang: Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Digestive Endoscopy Center, Changhai Hospital, Naval Medical University, Shanghai, China
Liang-Hao Hu: Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Digestive Endoscopy Center, Changhai Hospital, Naval Medical University, Shanghai, China; Shanghai Institute of Pancreatic Diseases, Shanghai, China
Yang-Yang Qian: Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Digestive Endoscopy Center, Changhai Hospital, Naval Medical University, Shanghai, China
David N. Cooper: Institute of Medical Genetics, School of Medicine, Cardiff University, Cardiff, UK
Claude Férec: EFS, Univ Brest, Inserm, UMR 1078, GGB, Brest, France
Zhao-Shen Li: Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Digestive Endoscopy Center, Changhai Hospital, Naval Medical University, Shanghai, China; Shanghai Institute of Pancreatic Diseases, Shanghai, China
Jian-Min Chen: EFS, Univ Brest, Inserm, UMR 1078, GGB, Brest, France
Zhuan Liao: Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Digestive Endoscopy Center, Changhai Hospital, Naval Medical University, Shanghai, China; Shanghai Institute of Pancreatic Diseases, Shanghai, China; Correspondence: Address correspondence to: Zhuan Liao, MD, Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China.

Journal volume & issue: Vol. 2, no. 2
pp. 186 – 195

Abstract

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Background and Aims: Heavy alcohol consumption and genetic factors represent the 2 major etiologies of chronic pancreatitis (CP). However, little is so far known about the clinical features and genetic basis of light-to-moderate alcohol consumption-related CP (LMA-CP). Methods: A cross-sectional analysis was performed on 1061 Chinese CP patients between 2010 and 2015. CP was classified as classical alcoholic CP (ACP; n = 206), LMA-CP (n = 154), and idiopathic CP (ICP; n = 701). Clinical features and genetic characteristics (PRSS1, SPINK1, CTRC, CFTR variant status) were compared between the different groups. Odds ratios (ORs) with 95% confidence intervals were calculated to ascertain the combinatorial effect of alcohol consumption and gene mutation. Results: Compared with ICP, the clinical features of LMA-CP were characterized by higher rates of developing pancreatic stones, pseudocyst, diabetes, and steatorrhea, which were similar to those associated with ACP. The prevalence of CP-related gene variants in LMA-CP was 38.3%, similar to ACP (39.8%), although significantly lower than ICP (56.2%). Alcohol consumption enhanced the risk of a poor clinical outcome, whereas genetic factors amplified alcohol’s effects. Compared with ICP, LMA-CP and ACP were associated with a high risk of pancreatic stones (patients without variants, OR = 2.01 and 2.54; patients with variants, OR = 2.17 and 1.07), pseudocyst (patients without variants, OR = 1.03 and 1.43; patients with variants, OR = 1.67 and 2.14), diabetes mellitus (patients without variants, OR = 0.86 and 1.31; patients with variants, OR = 2.05 and 1.55), and steatorrhea (patients without variants, OR = 1.56 and 2.10; patients with variants, OR = 2.11 and 1.60). Conclusion: Evidence was presented to show that LMA-CP was clinically and genetically similar to ACP but significantly different from ICP. Our findings provide support to the growing view that there is no safe level of alcohol consumption.

Published in Gastro Hep Advances

ISSN: 2772-5723 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the digestive system. Gastroenterology
Website: https://www.sciencedirect.com/journal/gastro-hep-advances

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