Study on the etiology of severe acute pancreatitis in Tibetan population at high altitude area

Objective To study the etiology of severe acute pancreatitis (SAP) in Tibetan population at high altitude area. Methods Data of patients with acute pancreatitis (AP) from January 2013 to January 2016 were retrospectively collected.Tibetan and Han patients were selected. According to AP diagnosis criteria, the patients were divided into SAP and non-severe acute pancreatitis (NSAP). Chi square test and multiple Logistic regression analysis were used for data analysis. Results There were 53 Tibetan SAP patients, 98 Tibetan NSAP patients, and 47 Han SAP patients.The results of etiology analysis indicated that the ratios of biliary diseases caused pancreatitis in Tibetan SAP patients, Tibetan NSAP patients and Han SAP patients were 5.7% (3/53), 51.0% (50/98) and 6.4% (3/47), respectively; those alcohol caused pancreatitis were 39.6% (21/53), 10.2% (10/98) and 34.0% (16/47), respectively; those hyperlipidemia caused pancreatitis were 39.6% (21/53), 9.2% (9/98) and 40.4% (19/47), respectively; those drug caused pancreatitis were 1.9% (1/53), 2.0% (2/98) and 2.1% (1/47), respectively; those infection caused pancreatitis were 1.9%(1/53), 6.1%(6/98) and 2.1%(1/47), respectively; those trauma caused pancreatitis were 1.9%(1/53), 5.1%(5/98) and 2.1%(1/47), respectively; those other reasons were 3.8% (2/53), 13.3% (13/98) and 4.3% (2/47), respectively; and those unexplained pancreatitis were 5.7% (3/53), 3.1% (3/98) and 8.5% (4/47), respectively. The ratio of biliary diseases caused pancreatitis in Tibetan SAP patients was lower than that of Tibetan NSAP patients (5.7%, 3/53 vs 51.0%, 50/98), however the ratios of alcohol and hyperlipidemia higher than those of Tibetan NSAP patients (39.6%, 21/53 vs 10.2%, 10/98; 39.6%, 21/53 vs 9.2%, 9/98), and the differences were statistically significant (χ2=31.069, 18.246 and 20.019, all P 0.05). Conclusion The etiology of SAP in high altitude Tibetan people is different from that of NSAP, however there is no difference in etiology of SAP between Tibetan and Han in the same area. Key words: High altitude localities; Severe acute pancreatitis; Non-severe acute pancreatitis; Tibetan