Key result
Higher BMI linked to ~180% greater acute pancreatitis risk, partially mediated by elevated triglycerides.
Why the study?
The incidence of acute pancreatitis is rising worldwide without curative treatments, motivating clarification of whether the risk associated with BMI is partly mediated through elevated triglycerides.
Does higher BMI increase the risk of acute pancreatitis in the general population?
Cohort (n=118,085)
Yes
Does higher BMI increase the risk of acute pancreatitis in the general population?
Hazard Ratio: 2.8 (95% CI 1.8–4.3)
Higher BMI is associated with an increased risk of acute pancreatitis, an effect that is partially mediated by elevated triglyceride levels.
Supports obesity as pancreatitis risk marker in counseling; leaves open causal mediation by triglycerides pending trials.
OBJECTIVE: The incidence of acute pancreatitis is rising worldwide and currently no curative treatment exists. Clarification of preventable risk factors is important for the reduction of morbidity and mortality from acute pancreatitis. In this study, we tested the hypothesis that the risk of acute pancreatitis associated with body mass index (BMI) is partly mediated through elevated triglycerides. DESIGN: We included 118 085 individuals from 2 prospective cohort studies, the Copenhagen City Heart Study and the Copenhagen General Population Study, with BMI measured at baseline. Diagnosis of acute pancreatitis was assessed from the national Danish registries, as hospitalization or death due to acute pancreatitis. RESULTS: Higher BMI was associated with higher risk of acute pancreatitis with a multivariable-adjusted hazard ratio of 1.4 (95% CI, 1.1-1.8) for BMI of 25-29.9, 2.1 (1.6-2.9) for BMI of 30-34.9, and 2.8 (1.8-4.3) for BMI > 35, compared with individuals with BMI of 18.5-24.9. Triglycerides mediated 29% (95% CI, 12%-46%; P = 0.001) of the association between BMI and risk of acute pancreatitis in the age- and sex-adjusted model and 22% (6%-39%; P = 0.008) in the multivariable-adjusted model. CONCLUSION: Higher BMI is associated with higher risk of acute pancreatitis in individuals from the general population, partly mediated through higher triglycerides. This indicates a potential for preventing acute pancreatitis by reducing BMI and triglycerides in individuals with high values.
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Hansen et al. (2019) conducted a cohort in Acute pancreatitis (n=118,085). Higher BMI vs. BMI of 18.5-24.9 was evaluated on Acute pancreatitis (hospitalization or death) (HR 2.8, 95% CI 1.8-4.3). Higher BMI was associated with an increased risk of acute pancreatitis (HR 2.8; 95% CI 1.8-4.3 for BMI >35 vs 18.5-24.9), with 22% of this association mediated by elevated triglycerides.
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