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ObjectiveTo investigate the influence of dyslipidemia and number of items conforming to the diagnostic criteria for dyslipidemia on new-onset acute pancreatitis (AP). MethodsA prospective cohort study was performed for 99 695 on-the-job or retired workers of Kailuan Group who underwent the first physical examination from 2006 to 2007. According to the number of items conforming to the diagnostic criteria for dyslipidemia in the first physical examination, they were divided into G0 group with 69 465 workers who did not meet the diagnostic criteria for dyslipidemia, G1 group with 23 921 workers who met one item of the diagnostic criteria for dyslipidemia, G2 group with 5791 workers who met two items of the diagnostic criteria for dyslipidemia, G3 group with 500 workers who met three items of the diagnostic criteria for dyslipidemia, and G4 group with 18 workers who met four items of the diagnostic criteria for dyslipidemia. New-onset AP cases were collected once every year during follow-up, and a multivariate Cox proportional hazards regression model analysis was used to analyze the influence of dyslipidemia on new-onset AP cases. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to calculate the cumulative incidence rate of AP in each group, and the log-rank test was used for comparison of cumulative incidence rate between groups. ResultsThe total follow-up time of all 99 695 workers was 782 395 person-years, and since no new-onset AP cases were observed in G4 group, G4 group was combined with G3 group for analysis. The incidence rates of AP in G0, G1, G2, and G3 groups were 1.61, 2.05, 2.59, and 7.72 per thousand person-years, respectively, and the cumulative incidence rates of AP in these four groups were 1.76‰, 2.40‰, 3.12‰, and 8.39‰, respectively. The log-rank test showed a significant difference in cumulative incidence rate between groups (χ2=15.18, P=0.004 3). After adjustment for the other risk factors, the Cox model showed that the hazard ratio (95% confidence interval) for AP was 1.23 (0.88-1.73) in G1 group, 1.58 (1.09-2.10) in G2 group, and 4.90 (1.81-13.37) in G3 group. ConclusionDyslipidemia is a risk factor for new-onset AP, and the risk of AP increases with the increase in the number of items conforming to the diagnostic criteria for dyslipidemia.
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Objective To investigate the effects of fasting serum triglycerides (TG) levels at different baseline on the risk of new-onset acute pancreatitis (AP) in in-service and retired employees of Kailuan Group.Methods A total of 125 178 in-service and retired employees of Kailuan Group who received health check-ups from 2006 to 2009 and had no AP history but had complete TG data were prospectively enrolled.According to quantile level,the baseline serum fasting TG level of study subjects were divided into ＜1.01 mmol/L group (n=42 128),1.01 to 1.64 mmol/L group (n=41 711) and ＞ 1.64 mmol/L group (n=41 339).The incidence of new-onset AP of these three groups was analyzed.The survival curve was plotted by Kaplan-Meier method.The cumulative incidence rate was calculated and tested by log-rank method.And multivariate Cox proportional hazards regression model was performed to calculate hazard ratios (HR) of baseline fasting serum TG level for AP.Results After followed up for (7.36±1.23) years,a total of 193 cases of AP occurred.The incidences of AP in ＜1.01 mmol/L group,1.01 to 1.64 mmol/L group and ＞ 1.64 mmol/L group were 1.43 events/10 000 person-years,2.37 events/10 000 person-years and 2.49 events/10 000 person-years,respectively.The cumulative incidence rates of AP in ＜1.01 mmol/L group,1.01 to 1.64 mmol/L group and ＞1.64 mmol/L group were 0.10％ (44/42 128),0.18％ (73/41 711) and 0.18％ (76/41 339),respectively,and the difference was statistically significant (x2 =9.998,P=0.007).The results of multivariate Cox proportional hazards regression model analysis indicated that the risk of AP increased in 1.01 to 1.64 mmol/L group and ＞ 1.64 mmol/L group compared with that of ＜1.01 mmol/L group,HR and 95％ confidence interval (CI) were 1.56 (1.07 to 2.29) and 1.57 (1.06 to 2.32),respectively.After excluded onset AP within one year,with a control group of ＜1.01 mmol/L group,the results of multivariate Cox proportional hazards regression model analysis indicated that the HR and 95％CI for AP of 1.01 to 1.64 mmol/L group and ＞ 1.64 mmol/L group were 1.70 (1.11 to 2.58) and 1.69 (1.10 to 2.60),respectively.Conclusion Baseline fasting serum TG levels over 1.01 mmol/L may increase the risk of AP.
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<p><b>OBJECTIVE</b>To investigate the effect of body mass index (BMI) on new-onset non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM).</p><p><b>METHODS</b>Subjects with T2DM were recruited from the population of individuals attending the Affiliated General Hospital of North China University for routine health examination between 2006 and 2007 and offered participation in this community-based prospective cohort study. Enrollees were categorized into groups according to weight assessed by baseline BMI (underweight, normal, overweight, and obese groups). Cumulative incidence of NAFLD was compared between each group and the effect of baseline BMI on new-onset NAFLD was assessed by Cox regression analysis.</p><p><b>RESULTS</b>The cumulative incidence of NAFLD increased in conjunction with increases in weight (low weight: 69%, normal weight: 73%, overweight: 90%, obese: 97%; P<0.01). Subjects in the overweight and obese groups showed an increased risk of NAFLD (relative risk (RR)=2.00, 95% CI: 1.76-2.29 and =2.87, 95% CI: 2.42-3.40; P<0.01), compared to those in the normal weight group. Moreover, after adjustment for baseline factors (e.g.age, sex) risk of NAFLD remained higher for the overweight and obese subjects (RR=1.73, 95% CI: 1.49-2.00 and =2.12, 95% CI: 1.73-2.60; P<0.01).</p><p><b>CONCLUSION</b>Risk of NAFLD in T2DM patients increases in parallel to increase in weight assessed by BMI. BMI appeared to be an independent risk factor for NAFLD.</p>