Medical College of Wisconsin
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Impact of Obesity on Pediatric Acute Recurrent and Chronic Pancreatitis. Pancreas 2018 Sep;47(8):967-973

Date

07/31/2018

Pubmed ID

30059474

Pubmed Central ID

PMC6095802

DOI

10.1097/MPA.0000000000001120

Scopus ID

2-s2.0-85051951074 (requires institutional sign-in at Scopus site)   28 Citations

Abstract

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.

Author List

Uc A, Zimmerman MB, Wilschanski M, Werlin SL, Troendle D, Shah U, Schwarzenberg SJ, Rhee S, Pohl JF, Perito ER, Palermo JJ, Ooi CY, Liu Q, Lin TK, Morinville VD, McFerron BA, Husain SZ, Himes R, Heyman MB, Gonska T, Giefer MJ, Gariepy CE, Freedman SD, Fishman DS, Bellin MD, Barth B, Abu-El-Haija M, Lowe ME

Author

Steven L. Werlin MD Emeritus Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Acute Disease
Body Mass Index
Child
Cohort Studies
Disease Progression
Female
Humans
Male
Obesity
Overweight
Pancreatitis
Pancreatitis, Chronic
Recurrence
Severity of Illness Index