BMJ open · 2023
Hypertriglyceridaemic waist phenotype and waist circumference triglyceride index are associated with higher incidence of acute pancreatitis: a nationwide population-based retrospective cohort study.
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Chung Kwang Hyun, Choi Young Hoon, Cho In Rae, Son Byoung Kwan, Ryu Ji Kon, Kim Yong-Tae, Lee Sang Hyub, Han Kyungdo
Аннотация
OBJECTIVES: The hypertriglyceridaemic waist (HTGW) phenotype, an indicator to assess metabolic syndrome, could be a useful predictive marker for the risk of acute pancreatitis. This study aimed to evaluate the association between the HTGW phenotype and the risk of acute pancreatitis with a nationwide population-based cohort.
DESIGN: A retrospective, nationwide cohort study.
SETTING: Registry of health check-up result from Korean National Health Insurance Service.
PARTICIPANTS: A total of 3 912 551 adults who underwent health checkups under the National Health Insurance Service in 2009 were enrolled in this study.
INTERVENTIONS: Subjects with both increased waist circumference (WC) and elevated blood triglyceride concentrations were defined as the HTGW phenotype. The participants were divided into four groups, classified as NWNT (normal WC-normal triglycerides), EWNT (elevated WC-normal triglycerides), NWET (normal WC-elevated triglycerides) and HTGW. The WC triglyceride index (WTI) is a quantitative indicator of the HTGW phenotype which is calculated by multiplying WC (cm) by triglyceride levels (mmol/L).
PRIMARY OUTCOME MEASURE: The subjects were followed until 31 December 2018. The adjusted HRs of acute pancreatitis in each group were estimated.
RESULTS: During the follow-up, there were a total of 8933 of acute pancreatitis occurrences. The incidence of acute pancreatitis in all subjects was 0.278 per 1000 person-year. The HTGW group had the highest incidence (0.444), followed by the NWET (0.381), and EWNT (0.316) groups. The HTGW group had a significant higher incidence of acute pancreatitis than the NWNT groups (HR 1.364 (95% CI 1.279 to 1.454)). The risk of acute pancreatitis steadily increased as the WTI increased (HR 1.847 (95% CI 1.657 to 2.058) in 10th decile).
CONCLUSIONS: The HTGW phenotype is confirmed to be an independent risk factor that increases the risk of acute pancreatitis.
DESIGN: A retrospective, nationwide cohort study.
SETTING: Registry of health check-up result from Korean National Health Insurance Service.
PARTICIPANTS: A total of 3 912 551 adults who underwent health checkups under the National Health Insurance Service in 2009 were enrolled in this study.
INTERVENTIONS: Subjects with both increased waist circumference (WC) and elevated blood triglyceride concentrations were defined as the HTGW phenotype. The participants were divided into four groups, classified as NWNT (normal WC-normal triglycerides), EWNT (elevated WC-normal triglycerides), NWET (normal WC-elevated triglycerides) and HTGW. The WC triglyceride index (WTI) is a quantitative indicator of the HTGW phenotype which is calculated by multiplying WC (cm) by triglyceride levels (mmol/L).
PRIMARY OUTCOME MEASURE: The subjects were followed until 31 December 2018. The adjusted HRs of acute pancreatitis in each group were estimated.
RESULTS: During the follow-up, there were a total of 8933 of acute pancreatitis occurrences. The incidence of acute pancreatitis in all subjects was 0.278 per 1000 person-year. The HTGW group had the highest incidence (0.444), followed by the NWET (0.381), and EWNT (0.316) groups. The HTGW group had a significant higher incidence of acute pancreatitis than the NWNT groups (HR 1.364 (95% CI 1.279 to 1.454)). The risk of acute pancreatitis steadily increased as the WTI increased (HR 1.847 (95% CI 1.657 to 2.058) in 10th decile).
CONCLUSIONS: The HTGW phenotype is confirmed to be an independent risk factor that increases the risk of acute pancreatitis.