Social disparity is associated with an increased risk of acute and chronic pancreatitis

Author:

Becker Ulrik1ORCID,Timmermann Amalie1,Ekholm Ola1,Drewes Asbjørn Mohr23,Novovic Srdan4,Nøjgaard Camilla4,Olesen Søren Schou23,Tolstrup Janne Schurmann1

Affiliation:

1. University of Southern Denmark National Institute of Public Health, , DK-1455 Copenhagen, Denmark

2. Aalborg University Department of Clinical Medicine, , DK-9220 Aalborg, Denmark

3. Aalborg University Hospital Centre for Pancreatic Diseases & Mech-Sense, Department of Gastroenterology and Hepatology, , DK-9220 Aalborg, Denmark

4. Hvidovre University Hospital Gastrounit, , DK-2650 Hvidovre, Denmark

Abstract

Abstract Aim To study social disparity in acute pancreatitis (AP) and chronic pancreatitis (CP).We also aimed at exploring whether an interaction exists between alcohol intake and socioeconomic factors. Methods Prospective cohort study based on data from 271 696 men and women participating in the Danish National Health Surveys 2010, and 2013. Information on alcohol and smoking parameters, body mass index (BMI), diet, and education, were self-reported and information on family income was obtained from administrative registers. Outcome variables (acute and chronic pancreatitis) were obtained from national health registers. Results The incidence rate ratio (IRR) of developing AP and CP increased with decreasing family income. Compared to participants in the highest income quintile, participants in the lowest income quintile had 43 (95% CI: 14–80%), 99 (95% CI: 26–214%), and 56% (95% CI: 26–94%) higher incidence rates of AP, CP, and all pancreatitis, respectively. The associations persisted after adjustment for alcohol intake, smoking, BMI, and diet. Likewise, participants with only primary school education had an IRR for an AP of 1.30 (95% CI: 1.06–1.59) compared to those with higher education after adjustment for baseline year, age, and sex. We found no interactions between alcohol intake and income or between alcohol intake and education in relation to neither AP, CP, nor all pancreatitis. Conclusion This large prospective population study showed a significant social disparity in incidence rates of pancreatitis by family income, with higher rates among those with the lowest income and education independent of risk factors such as alcohol intake, smoking, BMI, and diet.

Publisher

Oxford University Press (OUP)

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