https://ijmri.de/index.php/jmsi
volume 4, issue 7, 2025
416
EPIDEMIOLOGICAL CHARACTERISTICS OF PANCREATIC LIPOMATOSIS,
HYPERCHOLESTEROLEMIA, AND ALKALINE PHOSPHATASE AS RISK
FACTORS FOR BILIARY PANCREATITIS
Suyunov Dilmurod Muminovich
Andijan State Medical Institute
Introduction.
Global studies have established that in more than 40% of cases, pathologies of the biliary tract
play a significant role in the development of pancreatitis. In such situations, pancreatitis arises
against the background of the following conditions: anomalies in the position and shape of the
gallbladder, strictures and cysts of the distal pancreatic duct and common bile duct, stenosis of
the sphincter of Oddi (in 52% of cases), chronic cholecystitis (in 42%), gallstone disease or
consequences of cholecystectomy (in 6%) (Tsuman I.G. et al., 2001). Up to 25% of cases of
pancreatitis in children are caused by gastrointestinal disorders (Moriville V.D. et al., 2010;
Kornienko E.A. et al., 2010).
According to data presented by Rizaev K.S., Shukurov B.I., and Sattarov B.S. (2022), in 20% of
patients with acute pancreatitis, pancreatic necrosis is diagnosed, which increases mortality to
20–30% due to infection of pancreatic necrosis, developing in 70% of cases.
Studies by Capp J. et al. (2019), Wadhwa V. et al. (2017), and Petrov M.S. et al. (2010) report
that mortality in acute pancreatitis is around 1%. However, in complicated and severe cases (with
pancreatic necrosis, multiple organ failure, or other complications), this rate can reach 40% or
increase up to 40-fold.
These data clearly demonstrate that biliary pancreatitis is a serious medical, economic, and social
problem. In patients with biliary tract disorders, multiple factors contribute to the development of
biliary pancreatitis.
Objective.
To study the epidemiological characteristics of pancreatic lipomatosis, hypercholesterolemia,
and elevated serum alkaline phosphatase levels as risk factors for biliary pancreatitis.
Materials and Methods.
This study investigated the epidemiological characteristics of the relationship between
hypercholesterolemia (HCh), pancreatic lipomatosis (PL), and elevated serum alkaline
phosphatase (ALP) levels with the development of biliary pancreatitis in 1500 geriatric patients
diagnosed with biliary pancreatitis.
Hypercholesterolemia was identified in one out of every four (25.0%) of the studied population
aged 60 to 90 years.
The prevalence of biliary pancreatitis among elderly individuals with confirmed
hypercholesterolemia was 41.0%, while among those without hypercholesterolemia it was only
https://ijmri.de/index.php/jmsi
volume 4, issue 7, 2025
417
5.3%. Thus, the prevalence of biliary pancreatitis in the presence of hypercholesterolemia was
more than eight times higher (
p
= 0.012).
The frequency of biliary pancreatitis across different age groups among individuals with and
without hypercholesterolemia is presented below.
Table 1.
Characteristics of the occurrence of biliary pancreatitis depending on the presence of
hypercholesterolemia
OR = 8,11; CI [5,59 – 11,77]; χ² = 154,43; p < 0,05
Pancreatic lipomatosis is reliably associated with an increased risk of developing biliary
pancreatitis [OR = 7.89].
The confidence interval and Fisher’s
p
-value also indicate the
statistical significance of the obtained results [95% CI: 5.48–11.35;
p
< 0.05].
Table 2. Epidemiological characteristics of the prevalence of pancreatic lipomatosis among
elderly individuals and its association with biliary pancreatitis
1.
Among individuals aged
60–74 years
, the prevalence of biliary pancreatitis was
40.0%
in the presence of hypercholesterolemia (HCh) and
6.1%
in its absence, indicating a
6.6-fold
higher prevalence
(
p
= 0.001).
2.
In the age group
75–89 years
, the rates were
42.9%
versus
3.5%
, i.e., more than
14
times higher
in the presence of HCh (
p
= 0.001).
3.
In individuals older than
90 years
, biliary pancreatitis was also diagnosed significantly
more often in the presence of HCh (
52.2%
) compared with its absence (
20.0%
).
Thus, the prevalence of biliary pancreatitis in the geriatric population with hypercholesterolemia
ranged from
41.0% to 52.2%
, significantly exceeding the rates observed in the control groups
[OR = 8.11; 95% CI: 9.59–11.77; χ² = 154.43;
p
< 0.05].
https://ijmri.de/index.php/jmsi
volume 4, issue 7, 2025
418
The epidemiological characteristics of the prevalence of
pancreatic lipomatosis
in the geriatric
population and its association with the development of biliary pancreatitis were also assessed.
Specific trends and features were confirmed and quantitatively presented in the form of an
analytical review of the obtained data.
Table 3
presents the epidemiological data on the prevalence of elevated alkaline phosphatase
(ALP) levels in elderly individuals and its relationship with biliary pancreatitis. According to the
table, the prevalence of biliary pancreatitis among individuals with elevated ALP (ALP+) was
33.3%
, while in those with normal ALP levels (ALP–) it was
24.1%
, i.e., the difference was
9.2%
(
p
= 0.726), which is not statistically significant.
In the
60–74 years
age group, biliary pancreatitis was observed in
34.4%
(ALP+) and
23.3%
(ALP–),
which
was
statistically
significant
(
p
<
0.05).
In the
≥90 years
age group, the rates were
30.3%
versus
60.0%
respectively (
p
< 0.05), which,
despite the reverse trend, also reached statistical significance.
Table 3. Epidemiological characteristics of the prevalence of alkaline phosphatasemia in
elderly individuals and its association with biliary pancreatitis.
RR = 1,73; CI [1,35 – 2,22]; χ² = 19,36;
p
< 0,05
An elevated level of alkaline phosphatase is reliably associated with an increased risk of
developing biliary pancreatitis up to 73% [OR = 1.73].
The confidence interval and Fisher’s
p
-value also confirm the statistical significance of this result [95% CI: 1.35–2.22;
p
< 0.05].
Conclusions
1.
Hypercholesterolemia
is one of the leading risk factors for the development of biliary
pancreatitis: it was established that in individuals with elevated cholesterol levels, the probability
of developing biliary pancreatitis is
8 times higher
compared to those with normal cholesterol
[OR = 8.11]. The confidence interval and Fisher’s
p
-value also confirm the statistical
significance of this result [95% CI: 5.59–11.77;
p
< 0.05].
2.
Pancreatic lipomatosis (PL)
occurs in
37.0%
of the geriatric population of the Fergana
region. Among individuals without signs of PL, biliary pancreatitis is diagnosed in only
6.4%
of
cases. Thus, the presence of lipomatosis increases the risk of developing biliary pancreatitis by
more than
six-fold
[RR = 7.89; 95% CI: 5.48–11.35; χ² = 155.9;
p
< 0.05].
3.
Elevated alkaline phosphatase (ALP+)
is a reliable risk factor for biliary pancreatitis in
elderly individuals — the disease is diagnosed in
one out of every three patients
with this
biochemical marker [RR = 1.73; 95% CI: 1.35–2.22; χ² = 19.36;
p
< 0.05].
https://ijmri.de/index.php/jmsi
volume 4, issue 7, 2025
419
Literature:
1. Akinosoglou K., Gogos C. Immune-modulating therapy in acute pancreatitis: fact or fiction.
// World journal of gastroenterology. 2014; 20(41):15200-15212.
2. Bang J.Y., Arnoletti J.P., Holt B.A. Sutton B., Hasan M.K., Navaneethan U., et al. An
endoscopic transluminal approach, compared with minimally invasive surgery, reduces
complications and costs for patients with necrotizing pancreatitis
3. Bellin M.D., Whitcomb D.S., Abberbock J. et al. Patient and disease characteristics
associated wich the presence of diabetes mellitus in adulta with chronic pancreatitis in t the
United states / Am J of Gastroenterol. - 2017; 112(9):1438-1461.
4. Bliss L.A., Yang C.J., Eskander M.F., et al. Surgical management of chronic pancreatitis:
current utilization in the United States. HPB (Oxford). 2015; 17(9):804-810
5. Boxhoorn L., Voermans R.P., Bouwense S.A., Bruno M.J., Verdonk R.C., Boermeester
M.A., van Santvoort H.C., Besselink M.G. Acute pancreatitis. // Lancet. 2020; 396:726-731.
6. Bruce J., Sanchez-Alvarez R., Sans M.D., Sugden S.A., Qi N., James A.D., Williams J.A.
Insulin protects acinar cells during pancreatitis by preserving glycolytic ATP supply to
calcinum pumps. Nature communications. 2021; 12(1):4384.
7. Connor S. Defining post-operative pancreatitis as a new pancreatic specific complication
following pancreatic resection. HPB (oxford). 2016; 18(8) 642:651
8. Freeman M.L., Werner J., van Santvoort H.C., et al. Intervetions for necrotizing pancreatitis:
summary of a multidisciplinary consensus conference. // Pancreas 2012; 41(8):1176-1194
