Risk factors for pancreatitis in older women: The Iowa Women's Health Study

Purpose: Pancreatitis-an inflammation of pancreas-is a severe and costly disease. Although many risk factors for pancreatitis are known, many pancreatitis cases, especially in elderly women, are of unknown etiology. Methods: Risk factors for acute pancreatitis (AP) and chronic pancreatitis (CP) were assessed in a prospective cohort (n=36,436 women, aged≥65years). Exposures were self-reported at baseline. Pancreatitis was ascertained by linkage to Medicare claims (1986-2004) categorized by a physician as follows: "AP", one AP episode (n=511) or "CP", 2+ AP or 1+ CP episodes (n=149). Results: Multivariable odds ratios (ORs) and 95% confidence intervals for AP and CP were calculated using multinomial logistic regression. Alcohol use was not associated with AP or CP. Heavy smoking (40+ vs. 0 pack-years) was associated with a twofold increased OR for CP. For body mass index greater than or equal to 30 versus less than 25kg/m², the ORs were 1.35 (1.07-1.70) for AP (P trend=009) and 0.59 (0.37-0.94) for CP (P trend=01). ORs for AP and CP were increased for hormone replacement therapy use, heart disease, and hypertension. There were positive significant associations between protein and total fat intake for CP and AP. Conclusions: We identified factors associated with AP and CP that may be specific to older women.