Is obesity a risk factor in acute pancreatitis? A meta-analysis

Martı́nez, Juan Gabriel; Sánchez‐Paya, José; Palazón, José Antonio; Suazo-Barahona, Jorge; Robles-Dı́az, Guillermo; Pérez‐Mateo, Miguel

doi:10.1159/000077025

Cited by 131 publications

(105 citation statements)

References 31 publications

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“…A recent meta-analysis concluded that obese patients (defined as those with a BMI >30) had more systemic and local complications but not greater mortality (57). In one recent report, the combination of APACHE-II and obesity (a classification termed APACHE-O) measured within the first 24 h of admission improved the prediction of severity in patients with acute pancreatitis (58).…”

Section: Diagnostic Guideline I: Look For Risk Factors Of Severity Atmentioning

confidence: 99%

Practice Guidelines in Acute Pancreatitis

Banks

Freeman

2006

Am J Gastroenterology

1,662

980

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Section: Diagnostic Guideline I: Look For Risk Factors Of Severity Atmentioning

confidence: 99%

Practice Guidelines in Acute Pancreatitis

Banks

Freeman

2006

Am J Gastroenterology

1,662

980

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“…Obesity increases risk of acute and chronic pancreatitis because of chronic inflammation [4,14]. In addition to this, obesity also affects the mortality, local or systemic complications of acute pancreatitis as a prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

Acute pancreatitis and Type 2 Diabetes Mellitus; who is guilty?

Küçükler¹,

Şimşek²,

Bağlıcaklıoğlu³

et al. 2015

Eur Res J

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Many factors play a role in the etiology of acute pancreatitis and its pathogenesis is not fully understood. Dipeptidyl peptidase 4 (DPP-4) inhibitors are a new group of agents for the treatment of Diabetes Mellitus (DM). There are some controversies about specific adverse events such as pancreatitis and hypersensitivity reactions. A 50-year-old morbid obese woman presented with upper abdomen pain after the eating food, nausea and vomiting. She was diagnosed with type 2 diabetes mellitus 7 years ago. Vildagliptin had been added to her treatment six months ago. Abdominal examination revealed epigastric tenderness with guarding. Laboratory data revealed elevated pancreatic enzymes. Abdominal computed tomography (CT) showed features of pancreatitis. Vildagliptin was stopped and patient's symptoms had diminished in parallel with normalization of pancreatic enzymes; and at the 5th day patient was discharged with healthy condition. She was free of symptoms and all laboratory data were normal at the 30th day after discharge. It is important to keep in mind that diabetic patients have an increased risk of pancreatitis which may be related to obesity, hyperlipidemia and/or drugs. Received: 23.03.2015; Accepted: 05.06.2015: Published Online: 04.07.2015 Alcohol and gallstones are the etiology of chronic pancreatitis in many adults. Other etiologic factors are biliary sludge and microlithiasis, smoking, hypertriglyceridemia, hypercalcemia, drugs, obesity, diabetes, infections and toxins, trauma, pancreas divisum, vascular disease, pregnancy and idiopathic [1]. Patients with diabetes mellitus have a 2 fold increase in the risk of pancreatitis due to factors such as obesity, gallstones, elevated triglycerides, and medications [2,3]. Obesity increases risk of pancreatitis and pancreas carcinoma due to increased inflammation [4]. Incretin mimetics, glucagon-like peptide-1 receptor (GLP-1R) agonists and DPP-4 inhibitors are new anti-diabetic agents which can cause pancreatitis as side effect. Postmarketing events of acute pancreatitis have been reported in patients receiving sitagliptin, vildagliptin, or saxagliptin. Most of the cases with pancreatitis are reported with sitagliptin among DPP-4 inhibitors; although there are a few case reports related to vildagliptin, too. In this paper, we report a case of acute pancreatitis which may be associated DPP-4 inhibitors, obesity or DM itself. Case Report ABSTRACT 74

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“…32,33 Obesity is also a risk factor for more severe disease. Patients with obesity had more systemic (ie, organ failure) and local complications such as abscess formation, necrosis, and pseudocysts.…”

Section: Obesitymentioning

confidence: 99%

“…Patients with obesity had more systemic (ie, organ failure) and local complications such as abscess formation, necrosis, and pseudocysts. 33 A recent study demonstrated a direct association of increased intrapancreatic adipocyte volume and increased body mass index with severe acute pancreatitis. 34 The mechanism is not yet defined.…”

Section: Obesitymentioning

confidence: 99%

Nutritional advice for prevention of acute pancreatitis: review of current opinion

Lowe¹,

Sevilla²

2012

NDS

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Pancreatitis is inflammation of the pancreas that can be acute and self-limiting or, in a small percentage of patients, recurrent. Patients with recurrent episodes of acute pancreatitis (RAP) often progress to chronic pancreatitis. Pancreatitis in all forms causes significant economic and social burdens. Prevention of RAP may decrease those burdens and halt progression to chronic disease. Unfortunately, no therapy has proven effective at altering the course of RAP. While enteral nutritional therapy plays an important role in the treatment of acute pancreatitis during episodes, nutritional advice provided to patients in an attempt to prevent recurrent episodes has not proven effective in most cases. Discontinuing alcohol consumption and treating dyslipidemia with diet and medication can help patients with these issues. In patients whose pancreatitis is associated with celiac disease or eosinophilic gastroenteritis, a gluten-free diet and avoidance of food allergens can be effective in stopping RAP. Advice to take pancreatic enzyme replacement therapy, lose weight, control diabetes, decrease dietary sucrose, decrease dietary fat or avoid monosodium glutamate has little to no evidence of efficacy. Some studies suggest that an antioxidant cocktail may decrease the frequency of RAP and the intensity of chronic pain, but the evidence is weak. Nutritional therapy may have a role in the treatment of patients with RAP. At present, there are no clear guidelines for nutritional advice to give these patients. More studies are needed to identify nutritional interventions that will benefit patients with RAP.

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Is obesity a risk factor in acute pancreatitis? A meta-analysis

Cited by 131 publications

References 31 publications

Practice Guidelines in Acute Pancreatitis

Practice Guidelines in Acute Pancreatitis

Acute pancreatitis and Type 2 Diabetes Mellitus; who is guilty?

Nutritional advice for prevention of acute pancreatitis: review of current opinion

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