Péter Hegyi1, Andrea Párniczky2, Markus M Lerch3, Andrea R G Sheel4, Vinciane Rebours5, Chris E Forsmark6, Marco Del Chiaro7, Jonas Rosendahl8, Enrique de-Madaria9, Ákos Szücs10, Kyoichi Takaori11, Dhiraj Yadav12, Cristian Gheorghe13, Zoltán Rakonczay14, Xavier Molero15, Kazuo Inui16, Atsushi Masamune17, Carlos Fernandez-Del Castillo18, Tooru Shimosegawa19, John P Neoptolemos20, David C Whitcomb12, Miklós Sahin-Tóth21. 1. Institute for Translational Medicine & Department of Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary; MTA-SZTE Momentum Translational Gastroenterology Research Group, Faculty of Medicine, University of Szeged, Szeged, Hungary; First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary. Electronic address: p.hegyi@tm-centre.org. 2. Institute for Translational Medicine & Department of Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Heim Pál National Institute of Pediatrics, Budapest, Hungary. 3. Department of Medicine, University Medicine Greifswald, Greifswald, Germany. 4. Department of Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, United Kingdom. 5. Pancreatology Unit, Beaujon Hospital, APHP, Paris, Université de Paris, Paris-Diderot, France. 6. Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, USA. 7. Division of Surgical Oncology, Department of Surgery - University of Colorado Anschutz Medical Campus, Denver, USA. 8. Department of Internal Medicine I, Martin Luther University, Halle, Germany. 9. Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain. 10. First Department of Surgery, Faculty of Medicine, Semmelweis University, Budapest, Hungary. 11. Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. 12. Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. 13. Center of Gastroenterology and Hepatology, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 14. Department of Pathophysiology, Faculty of Medicine, University of Szeged, Szeged, Hungary. 15. Exocrine Pancreas Research Unit, Hospital Universitari Vall d'Hebron - Institut de Recerca, Autonomous University of Barcelona, CIBEREHD, Barcelona, Spain. 16. Department of Gastroenterology, Second Teaching Hospital, Fujita Health University, Nagoya, Japan. 17. Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan. 18. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 19. Department of Gastroenterology, South Miyagi Medical Center, Ohgawara, Miyagi, Japan. 20. Department of General Surgery, University of Heidelberg, Heidelberg, Germany. 21. Department of Surgery, University of California Los Angeles, Los Angeles, CA, USA.
Abstract
BACKGROUND: Chronic pancreatitis (CP) is a complex inflammatory disease with remarkably impaired quality of life and permanent damage of the pancreas. This paper is part of the international consensus guidelines on CP and presents the consensus on factors elevating the risk for CP. METHODS: An international working group with 20 experts on CP from the major pancreas societies (IAP, APA, JPS, and EPC) evaluated 14 statements generated from evidence on four questions deemed to be the most clinically relevant in CP. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the level of evidence available per statement. To determine the level of agreement, the working group voted on the 14 statements for strength of agreement, using a nine-point Likert scale in order to calculate Cronbach's alpha reliability coefficient. RESULTS: Strong consensus and agreement were obtained for the following statements: Alcohol, smoking, and certain genetic alterations are risk factors for CP. Past history, family history, onset of symptoms, and life-style factors including alcohol intake and smoking history should be determined. Alcohol consumption dose-dependently elevates the risk of CP up to 4-fold. Ever smokers, even smoking less than a pack of cigarettes per day, have an increased risk for CP, as compared to never smokers. CONCLUSIONS: Both genetic and environmental factors can markedly elevate the risk for CP. Therefore, health-promoting lifestyle education and in certain cases genetic counselling should be employed to reduce the incidence of CP.
BACKGROUND:Chronic pancreatitis (CP) is a complex inflammatory disease with remarkably impaired quality of life and permanent damage of the pancreas. This paper is part of the international consensus guidelines on CP and presents the consensus on factors elevating the risk for CP. METHODS: An international working group with 20 experts on CP from the major pancreas societies (IAP, APA, JPS, and EPC) evaluated 14 statements generated from evidence on four questions deemed to be the most clinically relevant in CP. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the level of evidence available per statement. To determine the level of agreement, the working group voted on the 14 statements for strength of agreement, using a nine-point Likert scale in order to calculate Cronbach's alpha reliability coefficient. RESULTS: Strong consensus and agreement were obtained for the following statements: Alcohol, smoking, and certain genetic alterations are risk factors for CP. Past history, family history, onset of symptoms, and life-style factors including alcohol intake and smoking history should be determined. Alcohol consumption dose-dependently elevates the risk of CP up to 4-fold. Ever smokers, even smoking less than a pack of cigarettes per day, have an increased risk for CP, as compared to never smokers. CONCLUSIONS: Both genetic and environmental factors can markedly elevate the risk for CP. Therefore, health-promoting lifestyle education and in certain cases genetic counselling should be employed to reduce the incidence of CP.
Authors: Márk Félix Juhász; Nelli Farkas; Andrea Szentesi; Andrzej Wedrychowicz; Andreia Florina Nita; Natália Lásztity; Alexandra Tészás; István Tokodi; Áron Vincze; Bálint Eross; Ferenc Izbéki; László Czakó; Mária Papp; Péter Hegyi; Andrea Párniczky Journal: Front Med (Lausanne) Date: 2022-09-12
Authors: Anthony F Herzig; Emmanuelle Génin; David N Cooper; Emmanuelle Masson; Claude Férec; Jian-Min Chen Journal: Genes (Basel) Date: 2020-11-13 Impact factor: 4.096
Authors: Tarek El-Hamoly; Zoltán Hajnády; Máté Nagy-Pénzes; Edina Bakondi; Zsolt Regdon; Máté A Demény; Katalin Kovács; Csaba Hegedűs; Sahar S Abd El-Rahman; Éva Szabó; József Maléth; Péter Hegyi; László Virág Journal: Int J Mol Sci Date: 2021-03-30 Impact factor: 5.923
Authors: Jian-Min Chen; Anthony F Herzig; Emmanuelle Génin; Emmanuelle Masson; David N Cooper; Claude Férec Journal: Genes (Basel) Date: 2021-03-25 Impact factor: 4.096
Authors: Ryan D Baron; Andrea R G Sheel; Ammad Farooq; Jörg Kleeff; Pietro Contin; Christopher M Halloran; John P Neoptolemos Journal: Langenbecks Arch Surg Date: 2021-06-25 Impact factor: 3.445