TY - JOUR

T1 - Pancreatic calcifications associate with diverse aetiological risk factors in patients with chronic pancreatitis

T2 - A multicentre study of 1500 cases

AU - Olesen, Søren S.

AU - Lisitskaya, Maria Valeryevna

AU - Drewes, Asbjørn M.

AU - Novovic, Srdan

AU - Nøjgaard, Camilla

AU - Kalaitzakis, Evangelos

AU - Jensen, Nanna M.

AU - Engjom, Trond

AU - Erchinger, Friedemann

AU - Waage, Anne

AU - Hauge, Truls

AU - Haas, Stephan L.

AU - Vujasinovic, Miroslav

AU - Lindkvist, Björn

AU - Zviniene, Kristina

AU - Pukitis, Aldis

AU - Ozola-Zālīte, Imanta

AU - Okhlobystin, Alexey

AU - Parhiala, Mikael

AU - Laukkarinen, Johanna

AU - Frøkjær, Jens B.

AU - for the Scandinavian Baltic Pancreatic Club

PY - 2019

Y1 - 2019

N2 - Background: Pancreatic calcifications is a common finding in patients with chronic pancreatitis (CP), but the underlying pathophysiology is incompletely understood. Past studies for risk factors of calcifications have generally been focused on single parameters or limited by small sample sizes. The aim of this study was to explore several patient and disease characteristics and their associations with pancreatic calcifications in a large cohort of CP patients with diverse aetiological risk factors. Methods: This was a multicentre, cross-sectional study including 1509 patients with CP. Patient and disease characteristics were compared for patients with calcifications (n = 912) vs. without calcifications (n = 597). Multivariable logistic regression was performed to assess the parameters independently associated with calcifications. Results: The mean age of patients was 53.9 ± 14.5 years and 1006 (67%) were men. The prevalence of calcifications was 60.4% in the overall patient cohort, but highly variable between patients with different aetiological risk factors (range: 2–69%). On multivariate analysis, alcoholic aetiology (OR 1.76 [95% CI, 1.39–2.24]; p < 0.001) and smoking aetiology (OR 1.77 [95% CI, 1.39–2.26], p < 0.001) were positively associated with the presence of calcifications, while an autoimmune aetiology was negatively associated with calcifications (OR 0.15 [95% CI, 0.08–0.27], p < 0.001). Patients with pancreatic calcifications were more likely to have undergone pancreatic duct stenting (OR 1.59 [95%CI, 1.16–2.19], p = 0.004). Conclusion: The presence of pancreatic calcifications is associated with diverse aetiological risk factors in patients with CP. This observation attest to the understanding of CP as a complex disease and may have implications for disease classification.

AB - Background: Pancreatic calcifications is a common finding in patients with chronic pancreatitis (CP), but the underlying pathophysiology is incompletely understood. Past studies for risk factors of calcifications have generally been focused on single parameters or limited by small sample sizes. The aim of this study was to explore several patient and disease characteristics and their associations with pancreatic calcifications in a large cohort of CP patients with diverse aetiological risk factors. Methods: This was a multicentre, cross-sectional study including 1509 patients with CP. Patient and disease characteristics were compared for patients with calcifications (n = 912) vs. without calcifications (n = 597). Multivariable logistic regression was performed to assess the parameters independently associated with calcifications. Results: The mean age of patients was 53.9 ± 14.5 years and 1006 (67%) were men. The prevalence of calcifications was 60.4% in the overall patient cohort, but highly variable between patients with different aetiological risk factors (range: 2–69%). On multivariate analysis, alcoholic aetiology (OR 1.76 [95% CI, 1.39–2.24]; p < 0.001) and smoking aetiology (OR 1.77 [95% CI, 1.39–2.26], p < 0.001) were positively associated with the presence of calcifications, while an autoimmune aetiology was negatively associated with calcifications (OR 0.15 [95% CI, 0.08–0.27], p < 0.001). Patients with pancreatic calcifications were more likely to have undergone pancreatic duct stenting (OR 1.59 [95%CI, 1.16–2.19], p = 0.004). Conclusion: The presence of pancreatic calcifications is associated with diverse aetiological risk factors in patients with CP. This observation attest to the understanding of CP as a complex disease and may have implications for disease classification.

KW - Alcohol

KW - Calcifications

KW - Chronic pancreatitis

KW - Endoscopy

KW - Smoking

KW - Surgery

U2 - 10.1016/j.pan.2019.08.009

DO - 10.1016/j.pan.2019.08.009

M3 - Journal article

C2 - 31462382

AN - SCOPUS:85071077223

VL - 19

SP - 922

EP - 928

JO - Pancreatology

JF - Pancreatology

SN - 1424-3903

IS - 7

ER -