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

  • Author Footnotes
    # These authors share co-first authorship.
    Yuan-Chen Wang
    Footnotes
    # These authors share co-first authorship.
    Affiliations
    National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, Navy Medical University, Shanghai, China

    Shanghai Institute of Pancreatic Diseases, Shanghai, China
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  • Author Footnotes
    # These authors share co-first authorship.
    Wen-Bin Zou
    Correspondence
    Correspondence to: Dr. Wen-Bin Zou, National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China;
    Footnotes
    # These authors share co-first authorship.
    Affiliations
    National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, Navy Medical University, Shanghai, China

    Shanghai Institute of Pancreatic Diseases, Shanghai, China
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  • Author Footnotes
    # These authors share co-first authorship.
    Da-Hai Tang
    Footnotes
    # These authors share co-first authorship.
    Affiliations
    Department of Laboratory Diagnostics, Changhai Hospital, Navy Medical University, Shanghai, China
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  • Lei Wang
    Affiliations
    National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, Navy Medical University, Shanghai, China
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  • Liang-Hao Hu
    Affiliations
    National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, Navy Medical University, Shanghai, China

    Shanghai Institute of Pancreatic Diseases, Shanghai, China
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  • Yang-Yang Qian
    Affiliations
    National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, Navy Medical University, Shanghai, China
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  • David N. Cooper
    Affiliations
    Institute of Medical Genetics, School of Medicine, Cardiff University, Cardiff, United Kingdom
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  • Claude Férec
    Affiliations
    EFS, Univ Brest, Inserm, UMR 1078, GGB, F-29200 Brest, France
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  • Zhao-Shen Li
    Affiliations
    National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, Navy Medical University, Shanghai, China

    Shanghai Institute of Pancreatic Diseases, Shanghai, China
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  • Author Footnotes
    § These authors share co-senior authorship.
    Jian-Min Chen
    Footnotes
    § These authors share co-senior authorship.
    Affiliations
    EFS, Univ Brest, Inserm, UMR 1078, GGB, F-29200 Brest, France
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  • Author Footnotes
    § These authors share co-senior authorship.
    Zhuan Liao
    Correspondence
    Correspondence to: Prof. Zhuan Liao, National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China;
    Footnotes
    § These authors share co-senior authorship.
    Affiliations
    National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, Navy Medical University, Shanghai, China

    Shanghai Institute of Pancreatic Diseases, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    # These authors share co-first authorship.
    § These authors share co-senior authorship.
Open AccessPublished:September 23, 2022DOI:https://doi.org/10.1016/j.gastha.2022.09.009
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      Abstract

      Background & Aims

      Heavy alcohol consumption and genetic factors represent the two 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 upon 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 (OR) 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 whilst genetic factors amplified alcohol’s effects. Compared to 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).

      Conclusions

      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.

      Graphical abstract

      Keywords

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