关键词: 胰腺炎, 胆固醇, 高胆固醇血症, 高甘油三酯血症, 影响因素分析, 队列研究

Abstract:
Background　It is generally believed that hypertriglyceridemia （HTG） increases the risk of developing acute pancreatitis （AP）． However，the relationship between hypercholesterol and AP has not yet been confirmed.Objective　To investigate the effects of serum total cholesterol （TC） on the risk for new-onset AP.Methods　 A prospective cohort study design was applied.Study cohort consisted of 125 210 current employees and retired employees from Kailuan Group who participated in the health check-ups between 2006 and 2009 launched by the group，the starting point of follow-up was when the subjects completed the health examination, and the end point was new AP events，deaths or the end of follow-up （2014-12-31）.and had complete data on serum TC with no AP history at baseline.Participants were divided into normal blood lipid group（TC<5.2 mmol/L），borderline high blood lipid group （TC 5.2-<6.2 mmol/L） and high blood lipid group （TC≥6.2 mmol/L） according to the baseline fasting serum TC levels.Baseline data and incidence of new-onset AP data were collected.The survival curve was plotted by Kaplan-Meier method.The cumulative incidence was determined by Log-Rank method.Multivariate Cox proportional hazards regression model was used to explore the effect of baseline fasting serum TC level on new-onset AP.Results　The sex ratio，average age，BMI，systolic blood pressure，fasting blood glucose，high-density lipoprotein cholesterol （HDL-C），triglyceride，and length of education，rates of smoking，drinking，physical exercising，history of hypertension，and diabetes history differed significantly between the groups （P<0.05）． All of them received an average follow-up period of （7.4±1.2） years，during which 195 cases were found with AP.The density rates of AP were 1.99/10 000，1.81/10 000，and 3.64/10 000 persons-years，in normal，borderline high and high blood lipid groups，respectively.The cumulative incidence in normal，borderline high and high blood lipid groups，was 0.16%，0.14%，0.27%，respectively，showing a significant inter-group difference by Log-Rank test （χ2=12.37，P=0.002）． After adjusting for age，gender，BMI，HDL-C，TG，smoking，drinking，length of education，physical exercising，history of hypertension and history of diabetes，Cox regression analysis showed that compared with the normal blood lipid group，borderline high blood lipid group 〔HR=0.84，95%CI（0.59，1.19）〕 and high blood lipid group 〔HR=1.56，95%CI （1.06，2.31）〕 had a higher risk for AP.Conclusion　Baseline fasting serum TC level greater than or equal to 6.2 mmol/L increases the risk of developing AP.

Key words:
Pancreatitis, Cholesterol, Hypercholesterolemia, Hypertrigly ceridemia, Root cause analysis, Cohort studies