Acute pancreatitis risk in the diagnosis and management of inflammatory bowel disease: A critical focus.

Abstract

Objective: We explored the causal relationship between pancreatitis and various autoimmune diseases using bidirectional Mendelian randomization (MR).

Methods: We collected genome-wide association study summary data for four pancreatitis types and five autoimmune diseases to conduct our bidirectional MR analysis. The primary analysis was performed using the inverse variance weighted (IVW) method, complemented by MR Egger, weighted median, and weighted mode methods. Sensitivity analyses included Cochran's Q test for heterogeneity, MR-Egger regression for pleiotropy, and MR-PRESSO and leave-one-out analyses for outliers.

Results: The result of IVW revealed a significant association between genetically predicted inflammatory bowel disease (IBD) and an increased risk of acute pancreatitis (AP) (odds ratio [OR] = 1.07, 95% confidence interval [CI] = 1.03-1.12, P = 0.0015). Subsequent analyses further confirmed this association in IBD subtypes, with genetically predicted ulcerative colitis (UC) and Crohn's disease (CD) also showing increased risks of AP (UC: OR = 1.07, 95% CI = 1.02-1.13, P = 0.01; CD: OR = 1.05, 95% CI = 1-1.09, P = 0.03), affirming IBD as a risk factor for pancreatitis. Reverse analysis ruled out reverse causality and did not find a causal relationship between other immune diseases and pancreatitis.

Conclusion: These findings suggest that pancreatitis in IBD patients may arise from the disease itself, necessitating increased vigilance for AP during diagnosis and treatment.