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Impact of Obesity on Pediatric Acute Recurrent and Chronic Pancreatitis
Aliye Uc, M Bridget Zimmerman1, Michael Wilschanski2
1Department of Biostatistics, University of Iowa, Iowa City, IA.
Insights
Obesity in children may delay the first episode of acute pancreatitis and diagnosis of chronic pancreatitis (CP). Further research is needed to understand obesity's full impact on pediatric CP progression and severity.
Area of Science:
- Pediatric Gastroenterology
- Metabolic Disorders
- Pancreatic Diseases
Background:
- Pediatric pancreatitis is a significant health concern.
- The role of obesity in the development and progression of pediatric pancreatitis requires further investigation.
Purpose of the Study:
- To evaluate the influence of obesity on pediatric acute recurrent pancreatitis and chronic pancreatitis (CP).
Main Methods:
- Utilized the INSPPIRE cohort data, assessing body mass index (BMI) using CDC criteria.
- Employed Cochran-Armitage and Jonckheere-Terpstra tests to analyze trends and associations.
Main Results:
- Obesity was associated with a later age of first acute pancreatitis episode and CP diagnosis.
- Obese children showed a lower likelihood of CP and a higher likelihood of acute inflammation on imaging.
- Hypertriglyceridemia was more prevalent in overweight or obese children.
Conclusions:
- Overweight and obesity appear to delay the onset of acute pancreatitis and CP diagnosis in children.
- The long-term effects of obesity on pediatric chronic pancreatitis severity and progression warrant additional research.
Objective:
The aim of this study was to assess the impact of obesity on pediatric acute recurrent pancreatitis or chronic pancreatitis (CP).
Methods:
We determined body mass index (BMI) status at enrollment in INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) cohort using CDC criteria for pediatric-specific BMI percentiles. We used the Cochran-Armitage test to assess trends and the Jonckheere-Terpstra test to determine associations.
Results:
Of 446 subjects (acute recurrent pancreatitis, n = 241; CP, n = 205), 22 were underweight, 258 normal weight, 75 overweight, and 91 were obese. The BMI groups were similar in sex, race, and age at presentation. Hypertriglyceridemia was more common in overweight or obese. Obese children were less likely to have CP and more likely to have acute inflammation on imaging. Compared with children with normal weight, obese or overweight children were older at first acute pancreatitis episode and diagnosed with CP at an older age. Obese or overweight children were less likely to undergo medical or endoscopic treatment, develop exocrine pancreatic insufficiency, and require total pancreatectomy with islet autotransplantation. Diabetes was similar among all groups.
Conclusions:
Obesity or overweight seems to delay the initial acute pancreatitis episode and diagnosis of CP compared with normal weight or underweight. The impact of obesity on pediatric CP progression and severity deserves further study.
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