Aliye Uc, M Bridget Zimmerman1, Michael Wilschanski2, Steven L Werlin3, David Troendle4, Uzma Shah5, Sarah Jane Schwarzenberg6, Sue Rhee7, John F Pohl8, Emily R Perito7, Joseph J Palermo9, Chee Y Ooi10, Quin Liu11, Tom K Lin9, Veronique D Morinville12, Brian A McFerron13, Sohail Z Husain14, Ryan Himes15, Melvin B Heyman7, Tanja Gonska16, Matthew J Giefer17, Cheryl E Gariepy18, Steven D Freedman19, Douglas S Fishman15, Melena D Bellin6, Bradley Barth4, Maisam Abu-El-Haija9, Mark E Lowe20. 1. Department of Biostatistics, University of Iowa, Iowa City, IA. 2. Department of Pediatrics, Hadassah Hebrew University Hospital, Jerusalem, Israel. 3. Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI. 4. Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, TX. 5. Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA. 6. Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN. 7. Department of Pediatrics, University of California San Francisco, San Francisco, CA. 8. Department of Pediatrics, University of Utah, Salt Lake City, UT. 9. Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 10. Department of Pediatrics, School of Women's and Children's Health, Medicine, University of New South Wales and Sydney Children's Hospital, Randwick Sydney, Australia. 11. Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA. 12. Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada. 13. Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN. 14. Department of Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, PA. 15. Department of Pediatrics, Baylor College of Medicine, Houston, TX. 16. Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada. 17. Department of Pediatrics, Seattle Children's Hospital, Seattle, WA. 18. Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH. 19. Department of Internal Medicine, Harvard Medical School, Boston, MA. 20. Department of Pediatrics, Washington University School of Medicine, St Louis, MO.
Abstract
OBJECTIVE: The aim of this study was to assess the impact of obesity on pediatric acute recurrent pancreatitis or chronic pancreatitis (CP). METHODS: We determined body mass index (BMI) status at enrollment in INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) cohort using CDC criteria for pediatric-specific BMI percentiles. We used the Cochran-Armitage test to assess trends and the Jonckheere-Terpstra test to determine associations. RESULTS: Of 446 subjects (acute recurrent pancreatitis, n = 241; CP, n = 205), 22 were underweight, 258 normal weight, 75 overweight, and 91 were obese. The BMI groups were similar in sex, race, and age at presentation. Hypertriglyceridemia was more common in overweight or obese. Obese children were less likely to have CP and more likely to have acute inflammation on imaging. Compared with children with normal weight, obese or overweight children were older at first acute pancreatitis episode and diagnosed with CP at an older age. Obese or overweight children were less likely to undergo medical or endoscopic treatment, develop exocrine pancreatic insufficiency, and require total pancreatectomy with islet autotransplantation. Diabetes was similar among all groups. CONCLUSIONS: Obesity or overweight seems to delay the initial acute pancreatitis episode and diagnosis of CP compared with normal weight or underweight. The impact of obesity on pediatric CP progression and severity deserves further study.
OBJECTIVE: The aim of this study was to assess the impact of obesity on pediatric acute recurrent pancreatitis or chronic pancreatitis (CP). METHODS: We determined body mass index (BMI) status at enrollment in INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) cohort using CDC criteria for pediatric-specific BMI percentiles. We used the Cochran-Armitage test to assess trends and the Jonckheere-Terpstra test to determine associations. RESULTS: Of 446 subjects (acute recurrent pancreatitis, n = 241; CP, n = 205), 22 were underweight, 258 normal weight, 75 overweight, and 91 were obese. The BMI groups were similar in sex, race, and age at presentation. Hypertriglyceridemia was more common in overweight or obese. Obesechildren were less likely to have CP and more likely to have acute inflammation on imaging. Compared with children with normal weight, obese or overweight children were older at first acute pancreatitis episode and diagnosed with CP at an older age. Obese or overweight children were less likely to undergo medical or endoscopic treatment, develop exocrine pancreatic insufficiency, and require total pancreatectomy with islet autotransplantation. Diabetes was similar among all groups. CONCLUSIONS:Obesity or overweight seems to delay the initial acute pancreatitis episode and diagnosis of CP compared with normal weight or underweight. The impact of obesity on pediatric CP progression and severity deserves further study.
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