Søren S Olesen1, Maria Valeryevna Lisitskaya2, Asbjørn M Drewes3, Srdan Novovic4, Camilla Nøjgaard4, Evangelos Kalaitzakis5, Nanna M Jensen6, Trond Engjom7, Friedemann Erchinger8, Anne Waage9, Truls Hauge10, Stephan L Haas11, Miroslav Vujasinovic11, Björn Lindkvist12, Kristina Zviniene13, Aldis Pukitis14, Imanta Ozola-Zālīte14, Alexey Okhlobystin15, Mikael Parhiala16, Johanna Laukkarinen16, Jens B Frøkjær17. 1. Centre for Pancreatic Diseases, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Clinical Institute, Aalborg University, Aalborg, Denmark. Electronic address: soso@rn.dk. 2. Centre for Pancreatic Diseases, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Radiology, Aalborg University Hospital, Aalborg, Denmark. 3. Centre for Pancreatic Diseases, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Clinical Institute, Aalborg University, Aalborg, Denmark. 4. Department of Gastroenterology, Hvidovre University Hospital, Copenhagen, Denmark. 5. Copenhagen University Hospital/Herlev, University of Copenhagen, Copenhagen, Denmark. 6. Abdominalcenter K, Bispebjerg Hospital, Copenhagen, Denmark. 7. Department of Clinical Medicine, University of Bergen, Bergen, Norway; Haukeland University Hospital, Department of Medicine, Bergen, Norway. 8. Department of Clinical Medicine, University of Bergen, Bergen, Norway. 9. Department of Surgery, Oslo University Hospital, Oslo, Norway. 10. Department of Gastroenterology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. 11. Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden. 12. Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. 13. Department of Radiology, Lithuanian University of Health Sciences, Kaunas, Lithuania. 14. Centre of Gastroenterology, Hepatology and Nutrition, Pauls Stradins Clinical University Hospital, Riga, Latvia. 15. Chair of Internal Diseases Propedeutics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. 16. Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland; Cancer Center, Faculty of Medicine and Heath Technology, Tampere University, Tampere, Finland. 17. Clinical Institute, Aalborg University, Aalborg, Denmark; Department of Radiology, Aalborg University Hospital, Aalborg, Denmark.
Abstract
BACKGROUND: Pancreatic calcifications is a common finding in patients with chronic pancreatitis (CP), but the underlying pathophysiology is incompletely understood. Past studies for risk factors of calcifications have generally been focused on single parameters or limited by small sample sizes. The aim of this study was to explore several patient and disease characteristics and their associations with pancreatic calcifications in a large cohort of CP patients with diverse aetiological risk factors. METHODS: This was a multicentre, cross-sectional study including 1509 patients with CP. Patient and disease characteristics were compared for patients with calcifications (n = 912) vs. without calcifications (n = 597). Multivariable logistic regression was performed to assess the parameters independently associated with calcifications. RESULTS: The mean age of patients was 53.9 ± 14.5 years and 1006 (67%) were men. The prevalence of calcifications was 60.4% in the overall patient cohort, but highly variable between patients with different aetiological risk factors (range: 2-69%). On multivariate analysis, alcoholic aetiology (OR 1.76 [95% CI, 1.39-2.24]; p < 0.001) and smoking aetiology (OR 1.77 [95% CI, 1.39-2.26], p < 0.001) were positively associated with the presence of calcifications, while an autoimmune aetiology was negatively associated with calcifications (OR 0.15 [95% CI, 0.08-0.27], p < 0.001). Patients with pancreatic calcifications were more likely to have undergone pancreatic duct stenting (OR 1.59 [95%CI, 1.16-2.19], p = 0.004). CONCLUSION: The presence of pancreatic calcifications is associated with diverse aetiological risk factors in patients with CP. This observation attest to the understanding of CP as a complex disease and may have implications for disease classification.
BACKGROUND:Pancreatic calcifications is a common finding in patients with chronic pancreatitis (CP), but the underlying pathophysiology is incompletely understood. Past studies for risk factors of calcifications have generally been focused on single parameters or limited by small sample sizes. The aim of this study was to explore several patient and disease characteristics and their associations with pancreatic calcifications in a large cohort of CP patients with diverse aetiological risk factors. METHODS: This was a multicentre, cross-sectional study including 1509 patients with CP. Patient and disease characteristics were compared for patients with calcifications (n = 912) vs. without calcifications (n = 597). Multivariable logistic regression was performed to assess the parameters independently associated with calcifications. RESULTS: The mean age of patients was 53.9 ± 14.5 years and 1006 (67%) were men. The prevalence of calcifications was 60.4% in the overall patient cohort, but highly variable between patients with different aetiological risk factors (range: 2-69%). On multivariate analysis, alcoholic aetiology (OR 1.76 [95% CI, 1.39-2.24]; p < 0.001) and smoking aetiology (OR 1.77 [95% CI, 1.39-2.26], p < 0.001) were positively associated with the presence of calcifications, while an autoimmune aetiology was negatively associated with calcifications (OR 0.15 [95% CI, 0.08-0.27], p < 0.001). Patients with pancreatic calcifications were more likely to have undergone pancreatic duct stenting (OR 1.59 [95%CI, 1.16-2.19], p = 0.004). CONCLUSION: The presence of pancreatic calcifications is associated with diverse aetiological risk factors in patients with CP. This observation attest to the understanding of CP as a complex disease and may have implications for disease classification.
Authors: Søren S Olesen; Jakob L Poulsen; Srdan Novovic; Camilla Nøjgaard; Evangelos Kalaitzakis; Nanna M Jensen; Trond Engjom; Erling Tjora; Anne Waage; Truls Hauge; Stephan L Haas; Miroslav Vujasinovic; Giedrius Barauskas; Aldis Pukitis; Imanta Ozola-Zālīte; Alexey Okhlobystin; Mikael Parhiala; Johanna Laukkarinen; Asbjørn M Drewes Journal: United European Gastroenterol J Date: 2020-01-17 Impact factor: 4.623