Pancreatic calcifications are associated with diverse etiological risk factors in patients with chronic pancreatitis (CP), attesting to the complexity of CP as a disease, and possibly having implications for disease classification, according to a study published in Pancreatology.

The presence of pancreatic calcifications is a common finding in patients with CP, but the underlying pathophysiology is not well understood. This multicenter, cross-sectional study included data on 1509 participants with CP from the Scandinavian Baltic Pancreatic Club (SBPC) database as of April 2019. The average age of patients was 53.9 ± 14.5 years and 67% were men. Investigators explored a number of disease and patient characteristics and their associations with pancreatic calcifications. The characteristics of participants with calcifications (n=912) were compared with those of participants without calcifications (n=597). The parameters independently associated with calcifications were assessed using multivariate logistic regression. A threshold of P <.05 was used to determine significance.

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The overall prevalence of pancreatic calcifications was 60.4% (95% CI, 57.9-62.9%), but this rate varied significantly between participants with different etiological risk factors. Multivariate analysis showed that age at diagnosis (OR, 1.02; 95% CI, 1.01-11.03; P <.001), duration of CP (OR, 1.05; 95% CI, 1.03-1.08; P <.001), alcoholic etiology (OR, 1.76; 95% CI, 1.39-2.24; P <.001), and smoking etiology (OR, 1.77; 95% CI, 1.39-2.26; P <.001) were all significantly and independently associated with the presence of pancreatic calcifications, while an autoimmune etiology was negatively associated with the presence of calcifications (OR, 0.15; 95% CI, 0.08-0.27; P <.001). Participants with calcifications were also more likely to have undergone pancreatic duct stenting (OR, 1.59; 95% CI, 1.16-2.19; P =.004).


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The study was limited by its cross-sectional nature, by the fact that only a history of recurring pancreatitis was considered as a risk factor for pancreatic calcifications, by a lack of distinction between calcifications, by the limited participant population, and by the lack of data on number of acute pancreatitis attacks.

Nevertheless, investigators concluded, “The presence of pancreatic calcifications is associated with diverse aetiological risk factors in patients with CP. This finding attests to the understanding of CP as a complex disease and may have implications for the classification of this entity.”

Reference

Olesen SS, Lisitskaya MV, Drewes AM, et al. Pancreatic calcifications associate with diverse aetiological risk factors in patients with chronic pancreatitis: A multicentre study of 1500 cases [published online August 21, 2019]. Pancreatology. doi: 10.1016/j.pan.2019.08.009