Impact of cigarette smoking on recurrence of hyperlipidemic acute pancreatitis

Table 1 Clinical characteristics of the hyperlipidemic acute pancreatitis patients

Clinical	Non-smokers	Current-smokers	Ex-smokers	P value
parameter	No. or mean	No. or mean	No. or mean
N	41	36	11
Age (yr)	42.7 ± 2.0	39.1 ± 1.2	40.0 ± 2.2	0.446
Gender (M/F)	20/21	36/0	10/1	< 0.001a
Heavy alcohol drinking	4	12	2	0.037a
Smoking pack-years	0	13.5 ± 2.2	7.8 ± 2.9	< 0.001a
History of hyperlipemia	39	30	8	0.084
History of fatty liver	16	15	4	0.943
History of diabetes mellitus	10	14	5	0.258
History of hypertension	8	3	2	0.364
History of AP	13	20	3	0.065a
Leukocyte (× 109/L)	12.5 ± 0.5	13.1 ± 0.7	12.3 ± 1.1	0.506
Platelet count (× 109/L)	185.2 ± 11.8	171.7 ± 8.2	175.6 ± 20.1	0.680
Serum TG (mmol/L)	18.3 ± 1.7	15.1 ±1.5	17.1 ± 2.9	0.358
Serum CHOL (mmol/L)	9.0 ± 0.6	8.4 ± 0.6	8.0 ± 0.8	0.316
Serum amylase (U/L)	569.3 ± 104.5	507.7 ± 111.4	629.8 ± 121.9	0.270
Serum lipase (U/L)	1297.1 ± 228.1	874.1 ± 170.2	1214.4 ± 582.0	0.406
Serum calcium (mmol/L)	2.0 ± 0.04	2.1 ± 0.04	2.0 ± 0.08	0.197
SIRS	17	17	8	0.182
BISAP score	0.8 ± 0.1	0.8 ± 0.2	1.4 ± 0.3	0.224
Hospitalization (d)1	10.9 ± 0.8	8.6 ± 0.7	11.9 ± 1.6	0.015a
Recurrence of AP	4	18	1	< 0.001a
Repeated episodes of AP	16	28	4	0.001a

^aP < 0.05, current vs non-smokers;

¹Exclude those discharged without medical advice or transferred to a different hospital. AP: Acute pancreatitis; TG: Total triglyceride; CHOL: Cholesterol; SIRS: Systemic inflammatory response syndrome; BISAP: Bedside index for severity in acute pancreatitis.

Table 2 Univariate analysis of risk factors for recurrence of hyperlipidemic acute pancreatitis

Variable	n	Number of recurrence	HR (95%CI)	P value
Age (≤ 40/> 40, yr)	46/42	14/9	0.7 (0.3-1.6)	0.417
Gender (M/F)	66/22	20/3	2.4 (0.7-7.9)	0.168
Heavy alcohol drinking (Y/N)	18/70	6/17	1.4 (0.5-3.5)	0.507
Smoking history (Y/N)	47/41	19/4	4.3 (1.4-12.5)	0.009
Non-smokers	41	4	1 (ref.)	1 (ref.)
Current-smokers	36	18	5.1 (1.7-15.2)	0.003
Ex-smokers	11	1	1.1 (0.1-9.5)	0.959
Smoking pack-years (> 0 but < 10/≥ 10)	64/24	11/12	0.4 (0.2-0.9)	0.035
0	41	4	1 (ref.)	1 (ref.)
0 < PY < 10	23	7	3.8 (1.1-13.1)	0.032
≥ 10	24	12	4.6 (1.5-14.2)	0.009
History of hyperlipemia (Y/N)	77/11	18/5	0.5 (0.2-1.3)	0.141
History of fatty liver (Y/N)	35/53	9/14	1.0 (0.4-2.2)	0.917
History of diabetes mellitus (Y/N)	29/59	10/13	1.7 (0.7-3.9)	0.208
History of hypertension (Y/N)	13/75	2/21	0.7 (0.2-2.9)	0.585
History of AP (Y/N)	36/52	13/10	1.9 (0.8-4.4)	0.117
Leukocyte (< 10/≥ 10, × 109/L)	23/65	5/18	0.6 (0.2-1.7)	0.379
Platelet count (< 100/≥ 100, × 109/L)	4/84	1/22	0.8 (0.1-5.7)	0.790
Serum TG (≤ 11.3/> 11.3, mmol/L)	32/56	7/16	0.9 (0.4-2.2)	0.813
Serum CHOL (≤ 5.5/> 5.5, mmol/L)	16/72	4/19	1.0 (0.3-2.8)	0.934
Serum amylase (< 540/≥ 540, U/L)	62/26	18/5	1.6 (0.6-4.4)	0.335
Serum lipase (< 600/≥ 600, U/L)1	31/34	8/9	0.6 (0.2-1.5)	0.273
Serum calcium (< 2.0/≥ 2.0, mmol/L)	28/60	8/15	1.0 (0.4-2.3)	0.918
SIRS (Y/N)	42/46	11/12	1.1 (0.5-2.4)	0.858
BISAP score (< 2/≥ 2)	69/19	19/4	1.3 (0.5-3.9)	0.610

¹Data of the parameter in 65 of patients were available. AP: Acute pancreatitis; TG: Total triglyceride; CHOL: Cholesterol; SIRS: Systemic inflammatory response syndrome; BISAP: Bedside index for severity in acute pancreatitis; HR: Hazard ratio; CI: Confidence interval.

Table 3 Mutivariate analysis of risk factors for recurrence of hyperlipidemic acute pancreatitis

Variable	Hazard ratio	95%CI	P value
Gender (Male)	0.5	0.1-3.0	0.449
Smoking history (Current)	6.3	1.3-29.8	0.020
Smoking pack-years (≥ 10)	1.0	0.4-2.7	0.969
History of hyperlipemia (Yes)	0.7	0.2-1.8	0.435
History of AP (Yes)	1.4	0.6-3.3	0.422

AP: Acute pancreatitis; CI: Confidence interval.