Zhongguo quanke yixue (Sep 2022)
Baseline Triglyceride and Risk of Acute Pancreatitis in a Nonobese Health Check-up Population: a Prospective Cohort Study
Abstract
Background Hypertriglyceridemia has been increasingly valued as a risk factor for acute pancreatitis (AP) . However, the relationship between obesity and AP has not yet been confirmed, whether baseline triglyceride (TG) affects the risk of AP in non-obese people is still inconclusive. Objective To explore the association between baseline serum triglyceride (TG) and the risk of AP in a nonobese cohort from Kailuan Group. Methods A prospective cohort study was performed among in-service and retired workers of Kailuan Group (non-obese, without a history of AP, with complete TG information) who first attended the annual health screening for workers of the group as a benefit conducted between 2006 and 2007 or between 2008-2009. The cumulative incidence of AP across serum TG tertile groups: 〔Q1 group (TG≤0.96 mmol/L) , Q2 group (0.96 mmol/L<TG<1.52 mmol/L) , Q3 group (TG≥1.52 mmol/L) 〕was described using Kaplan-Meier curve, and compared by the Log-rank test. The new AP event, death or the end of follow-up (December 31, 2020) was taken as the end point of follow-up. Cox regression model was used to estimate the association of baseline TG levels and new incidence of AP. Results The study included a total of 102 358 subjects. Q1, Q2 and Q3 groups had significant differences in sex ratio, average age, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol (TC) , low-density lipoprotein cholesterol (LDL-C) , and high-density lipoprotein cholesterol (HDL-C) , and prevalence of smoking, drinking, previous hypertension, previous diabetes, previous cholelithiasis, as well as having at least 9 years of education (P<0.05) . Three hundred and sixteen cases developed AP during an average follow-up of (12.8±2.4) years, with an incidence density of AP of 2.41 per 10 000 person-years. The incidence density was 1.82, 2.22, and 3.17 per 10 000 person-years in Q1, Q2, and Q3 groups, respectively. The cumulative incidence of AP was 2.33%, 2.85% and 4.07%, respectively, in Q1, Q2, and Q3 groups, with statistically differences detected by the log-rank test (χ2=17.27, P<0.001) . By the analysis based on COX regression model 3, the HR of developing AP in Q3 group was 1.66〔95%CI (1.25, 2.19) 〕times higher than in Q1 group after adjusting for sex, age, HDL-C, TC, smoking, drinking, education level, history of hypertension, history of diabetes and history of cholelithiasis, and it was 1.68〔95%CI (1.25, 2.24) 〕times higher than in Q1 group after further excluding the cases suffering from AP within 1 year of follow-up. Conclusion A baseline serum TG level of ≥ 1.52 mmol/L may increase the risk of AP in nonobese people.
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