Joseph Romagnuolo1, Jyothsna Talluri, Elizabeth Kennard, Bimaljit S Sandhu, Stuart Sherman, Gregory A Cote, Samer Al-Kaade, Timothy B Gardner, Andres Gelrud, Michele D Lewis, Christopher E Forsmark, Nalini M Guda, Darwin L Conwell, Peter A Banks, Thiruvengadam Muniraj, Stephen R Wisniewski, Ye Tian, C Mel Wilcox, Michelle A Anderson, Randall E Brand, Adam Slivka, David C Whitcomb, Dhiraj Yadav. 1. From the *Digestive Disorders Center, Medical University of South Carolina, Charleston, SC; †Department of Medicine, University of Pittsburgh Medical Center; ‡Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; §Department of Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA; ∥Department of Medicine, Indiana University School of Medicine, Indianapolis, IN; ¶Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO; #Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH; **Department of Medicine, Mayo Clinic, Jacksonville, FL; ††Department of Medicine, University of Florida College of Medicine, Gainesville, FL; ‡‡Department of Medicine, University of Wisconsin School of Medicine, Milwaukee, WI; §§Department of Medicine, Brigham and Women's Hospital, Boston, MA; ∥∥Department of Medicine, Griffin Hospital, Derby, CT; ¶¶Department of Medicine, University of Alabama at Birmingham Hospital, Birmingham, AL; and ##Department of Medicine, University of Michigan School of Medicine, Ann Arbor, MI.
Abstract
OBJECTIVE: Historically, chronic pancreatitis (CP) was considered a disease of alcoholic males, but recent data suggest its etiology to be complex. To better understand CP in women, we compared data on women and men with CP in a large, prospectively ascertained multicenter US cohort. METHODS: Patients with CP enrolled in the NAPS2 Continuation and Validation study were studied. Information on demographics, etiology, risk factors, phenotype, and treatment(s) used was obtained from detailed questionnaires completed by the patients and physicians. RESULTS: Of 521 cases, 45% were women. Women were significantly (P < 0.05) less likely to have alcohol etiology (30% vs 58.5%) and more likely to have nonalcoholic etiologies (idiopathic, 32% vs 18%; obstructive, 12% vs 2.4%; genetic, 12.8% vs 7.3%). Demographics, pain experience, morphologic findings, exocrine and endocrine insufficiency, CP-related disability, and use of medical therapies were mostly similar in both sexes. Sphincterotomy (biliary, 33% vs 24%; pancreatic, 38% vs 28%; P < 0.05) was performed more frequently in women, whereas cyst/pseudocyst operations were more common in men (6.6 vs 2.6%, P = 0.02). CONCLUSIONS: Most CP cases in women are from nonalcoholic etiologies. In contrast to many other chronic diseases, clinical phenotype of CP is determined by the disease and is independent of sex.
OBJECTIVE: Historically, chronic pancreatitis (CP) was considered a disease of alcoholic males, but recent data suggest its etiology to be complex. To better understand CP in women, we compared data on women and men with CP in a large, prospectively ascertained multicenter US cohort. METHODS:Patients with CP enrolled in the NAPS2 Continuation and Validation study were studied. Information on demographics, etiology, risk factors, phenotype, and treatment(s) used was obtained from detailed questionnaires completed by the patients and physicians. RESULTS: Of 521 cases, 45% were women. Women were significantly (P < 0.05) less likely to have alcohol etiology (30% vs 58.5%) and more likely to have nonalcoholic etiologies (idiopathic, 32% vs 18%; obstructive, 12% vs 2.4%; genetic, 12.8% vs 7.3%). Demographics, pain experience, morphologic findings, exocrine and endocrine insufficiency, CP-related disability, and use of medical therapies were mostly similar in both sexes. Sphincterotomy (biliary, 33% vs 24%; pancreatic, 38% vs 28%; P < 0.05) was performed more frequently in women, whereas cyst/pseudocyst operations were more common in men (6.6 vs 2.6%, P = 0.02). CONCLUSIONS: Most CP cases in women are from nonalcoholic etiologies. In contrast to many other chronic diseases, clinical phenotype of CP is determined by the disease and is independent of sex.
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