BMI Has No Effect on Severity of Acute Pancreatitis?

Abstract

Introduction: Acute pancreatitis is a common gastrointestinal disease often seen in daily practice. Obesity defined as body mass index (BMI) ≥30 kg/m2 has been shown to be a risk factor and a prognosticator in many populations. Many studies have found that obesity is a risk factor for severe acute pancreatitis. However, there is a recent single large cohort study showing the paradoxical result that being overweight and obese improved survival both 30 days and 1 year after ICU admission in adult patients. The aim of this study was to examine the effect of obesity on the severity of acute pancreatitis. Methods: A total of 135 patients with the diagnosis of acute pancreatitis were included in this retrospective study.Clinical data was collected. Our primary studied variable was overweight and obesity, defined by BMI>25 kg/m2 and >30 kg/m2, respectively, by WHO criteria. Severe pancreatitis was defined as a Ranson score at any time ≥3. Appropriate descriptive statistics and statistical tests were performed. Statistical significance was defined as a p<0.05. Results: The cohort consisted of 58% (78 of 135) men with a mean (SD) age of 50 (18) years. Of the 135 patients, 30 (22.22%) had gallstone pancreatitis, 20 (14.8%) had alcoholic pancreatitis, 2 (1.48%) had hypertriglceridemia pancreatitis, and 83 (61.48%) had pancreatitis of unknown etiology. Median (interquartile range) Ranson score on admission and 48 hours afterwards were 2 (1, 3) and 1 (0, 2), respectively. There were 43 patients (32%) on admission day and 19 patients (14%) at 48 hours after admission in the higher severity group. Being obese or overweight had no statistically significant difference in severity of acute pancreatitis on admission. At 48 hours after admission, obesity or overweight was not statistically different either (p=0.18 and 0.384 respectively) between the 2 severity groups, as shown on Table 2. Conclusion: This pilot study demonstrates that obesity or overweight has no effect on the severity of acute pancreatitis. Our study showed opposite findings from previous studies, in which obesity was found to be associated with a higher severity of pancreatitis.Table