From the Guidelines
The primary risk factors for pancreatitis include excess alcohol consumption, heavy smoking, hypertriglyceridemia, pancreatic obstruction, pancreas divisum, cystic fibrosis, hypercalcaemia, autoimmunity, and genetic mutations.
Risk Factors for Pancreatitis
- Alcohol consumption: The dominant aetiology for chronic pancreatitis in western countries is excess alcohol consumption 1.
- Smoking: Heavy smoking increases the risk of developing chronic pancreatitis 1.
- Hypertriglyceridemia: Triglyceride levels over 11.3 mmol/l (1000 mg/dl) indicate hypertriglyceridemia as the etiology of pancreatitis 1.
- Other causes: Other causes of pancreatitis include pancreatic obstruction, pancreas divisum, cystic fibrosis, hypercalcaemia, autoimmunity, and genetic mutations 1.
- Idiopathic cases: About a fifth of cases are deemed to be idiopathic 1.
- Triglyceride levels: The risk of acute pancreatitis is increased in patients with severe hypertriglyceridemia (triglycerides ≥500 mg/dL and especially ≥1,000 mg/dL) 1.
- Lifestyle interventions: Lifestyle interventions, including Medical Nutrition Therapy (MNT), are important for all patients with elevated triglycerides, with a very rigorous approach advised for patients with triglycerides ≥1,000 mg/dL 1.
- Laboratory parameters: Certain laboratory parameters, such as serum amylase and lipase, C-reactive Protein, hematocrit, urea, and procalcitonin, can be used to diagnose and prognosticate pancreatitis 1.
From the Research
Risk Factors for Pancreatitis
The risk factors for pancreatitis can be categorized into several groups, including:
- Genetic factors: Hereditary pancreatitis, mutations in the cationic trypsinogen gene (PRSS1), and germline variations in other genes have been identified as risk factors for chronic and acute pancreatitis 2, 3
- Environmental factors: Tobacco smoke, alcohol consumption, and hypertriglyceridemia have been found to increase the risk of pancreatitis 2, 4, 5
- Demographic factors: Age, gender, and body mass index (BMI) have been associated with an increased risk of pancreatitis 6, 5
- Medical history: History of post-ERCP pancreatitis, suspected sphincter of Oddi dysfunction (SOD), and recurrent idiopathic pancreatitis have been identified as risk factors for pancreatitis 4, 6
- Procedure-related factors: Endoscopic retrograde cholangiopancreatography (ERCP) and minor papilla sphincterotomy have been found to increase the risk of post-ERCP pancreatitis 6
Modifiable Risk Factors
Modifiable risk factors for pancreatitis include:
- Smoking: Genetically predicted smoking has been associated with an increased risk of acute and chronic pancreatitis 5
- Alcohol consumption: Genetically predicted alcohol drinking has been associated with an increased risk of alcohol-induced acute and chronic pancreatitis 5
- Hypertriglyceridemia: Higher triglycerides have been associated with an increased risk of acute and chronic pancreatitis 2, 5
- Obesity: Higher BMI, whole body fat mass, and waist circumference have been associated with an increased risk of acute pancreatitis 5
Other Risk Factors
Other risk factors for pancreatitis include:
- Cholelithiasis: Genetically predicted cholelithiasis has been associated with an increased risk of acute and chronic pancreatitis 5
- Inflammatory bowel disease (IBD): Genetically predicted IBD has been associated with an increased risk of acute and chronic pancreatitis 5
- Autoimmune diseases: Genetically predicted autoimmune diseases have been associated with an increased risk of chronic pancreatitis 5
- Type 2 diabetes: Genetically predicted type 2 diabetes has been associated with an increased risk of chronic pancreatitis 5