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. 2022 Jan 19;13(1):e00455.
doi: 10.14309/ctg.0000000000000455.

Acute and Chronic Pancreatitis Disease Prevalence, Classification, and Comorbidities: A Cohort Study of the UK BioBank

Daniel M Spagnolo  1   2 , Phil J Greer  1 , Celeste Shelton Ohlsen  1 , Shannon Mance  3 , Mitchell Ellison  1 , Cameron Breze  1 , Ben Busby  4 , David C Whitcomb  1   2   3   4 , Mark Haupt  1
Affiliations

Acute and Chronic Pancreatitis Disease Prevalence, Classification, and Comorbidities: A Cohort Study of the UK BioBank

Daniel M Spagnolo et al. Clin Transl Gastroenterol. .

Abstract

Introduction: Pancreatitis is a complex syndrome that results from many etiologies. Large well-characterized cohorts are needed to further understand disease risk and prognosis.

Methods: A pancreatitis cohort of more than 4,200 patients and 24,000 controls were identified in the UK BioBank (UKBB) consortium. A descriptive analysis was completed, comparing patients with acute (AP) and chronic pancreatitis (CP). The Toxic-metabolic, Idiopathic, Genetic, Autoimmune, Recurrent, and severe pancreatitis and Obstructive checklist Version 2 classification was applied to patients with AP and CP and compared with the control population.

Results: CP prevalence in the UKBB is 163 per 100,000. AP incidence increased from 21.4/100,000 per year from 2001 to 2005 to 48.2/100,000 per year between 2016 and 2020. Gallstones and smoking were confirmed as key risk factors for AP and CP, respectively. Both populations carry multiple risk factors and a high burden of comorbidities, including benign and malignant neoplastic disorders.

Discussion: The UKBB serves as a rich cohort to evaluate pancreatitis. Disease burden of AP and CP was high in this population. The association of common risk factors identified in other cohort studies was confirmed in this study. Further analysis is needed to link genomic risks and biomarkers with disease features in this population.

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Conflict of interest statement

Guarantor of the article: David C. Whitcomb MD, PhD.

Specific author contributions: P.G., B.B., and M.H. were involved in planning and conducting the study. D.S. and P.G. collected the data. D.S., P.G., and M.E. completed the data analysis. All authors contributed to data interpretation. D.S., P.G., S.M., C.B., M.H., and M.E. created the initial draft of the manuscript. All authors participated in manuscript revision and editing, and reviewed and approved the final draft of the manuscript submitted for review.

Financial support: No external funding sources were used for this analysis and manuscript preparation.

Potential competing interests: P.G. and C.S.O. are employees of Ariel Precision Medicine. M.E. and C.B. are consultants to Ariel Precision Medicine. D.C.W. is a cofounder of Ariel Precision Medicine and a chief scientific officer. B.B. is an employee of DNAnexus. D.S. and M.H. are former employees of Ariel Precision Medicine.

Figures

Figure 1.
Figure 1.
Study design and subject selection criteria. Step 1 (a) identifying all acute and chronic pancreatitis subjects from 6 separate data fields: 1.1 ICD-9 hospitalization data, 1.2 ICD-10 hospitalization data, 1.3 death records (primary and secondary), 1.4 self-reported, 1.5 date of first diagnosis K85, and 1.6 date of first diagnosis K86. All possible pancreatitis subjects are combined in 1.7. Step 2 (b) combining the list of analysis subjects using 2.1 all confirmed subjects with CP from the results of 1.1, 1.2, and 1.3 in step 1; 2.2 all confirmed subjects with AP from 1.1, 1.2, and 1.3 but excluding all subjects with CP from 2.1; and a random sample of controls excluding all possible pancreatitis identified in 1.7. AP, acute pancreatitis; CP, chronic pancreatitis; ICD-9 and ICD-10, International Classification of Disease 9th Revision and 10th Revision.
Figure 2.
Figure 2.
Manhattan plot of AP (a) and CP (b) comorbidities with other ICD-10 diagnoses by significance value. Each circle is scaled by the side of the odds ratio for that comorbidity. ICD-10 codes colored and labeled by ICD-10 chapter titles. Dashed line at Bonferroni corrected P-value of 9 × 10−6. AP, acute pancreatitis; CP, chronic pancreatitis; ICD-10, International Classification of Disease 10th Revision.
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