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. 2022 Sep 24;2(2):186-195.
doi: 10.1016/j.gastha.2022.09.009. eCollection 2023.

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

Yuan-Chen Wang  1   2 , Wen-Bin Zou  1   2 , Da-Hai Tang  3 , Lei Wang  1 , Liang-Hao Hu  1   2 , Yang-Yang Qian  1 , David N Cooper  4 , Claude Férec  5 , Zhao-Shen Li  1   2 , Jian-Min Chen  5 , Zhuan Liao  1   2
Affiliations

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

Yuan-Chen Wang et al. Gastro Hep Adv. .

Abstract

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.

Keywords: Chronic Pancreatitis; Clinical Features; Genetic Variants; Light-to-Moderate Alcohol Consumption.

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Figures

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Graphical abstract
Figure 1
Figure 1
Classification of chronic pancreatic (CP) subtypes using classically and newly defined criteria with respect to alcohol consumption. Total numbers of patients as well as subgroup patients used in the study are indicated.
Figure 2
Figure 2
Distribution of age at onset in ICP (A), LMA-CP (B) and ACP (C). formula image, patients without variants. formula image, patients with non-SPINK1 variants. formula image, patients with SPINK1 variants.
Figure 3
Figure 3
Associations of drinking patterns and genetic factors with disease features in patients with chronic pancreatitis. G−, without gene variants; G+, with gene variants.
See this image and copyright information in PMC

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