Associations with pancreatic exocrine insufficiency: An United Kingdom single-centre study

Table 1 Distribution of exposure variables in total cohort and by faecal elastase-1 result, and result from the univariable logistic regression analysis

Variable	Total cohort, n (%)	FE1 ≥ 200 μg/g, n (%)	FE1 < 200 μg/g, n (%)	OR (95%CI)	P value
Total	1027 (100)	845 (82.3)	182 (17.7)
Demographics
Age (yr) (mean ± SD)	53.01 (17.2)	52.29 (17.4)	56.42 (16.0)	1.01 (1.01-1.02)	0.003
Sex
Male	436 (42.5)	343 (40.6)	93 (51.1)	1.53 (1.11-2.11)	0.010
Ethnicity
Asian	159 (15.5)	116 (13.7)	43 (23.6)	2.02 (1.33-3.06)	0.001
Black	105 (10.2)	85 (10.1)	20 (11.0)	1.28 (0.75-2.19)	0.370
Other	203 (19.8)	171 (20.2)	32 (17.6)	1.02 (0.65-1.58)	0.939
Comorbidities
Type 1 diabetes	25 (2.4)	18 (2.1)	7 (3.9)	1.84 (0.76-4.46)	0.180
Type 2 diabetes	182 (17.7)	125 (14.8)	57 (31.3)	2.62 (1.82-3.78)	< 0.001
IBD	42 (4.1)	36 (4.3)	6 (3.3)	0.77 (0.32-1.84)	0.551
Liver cirrhosis	57 (5.6)	40 (4.7)	17 (9.3)	2.07 (1.15-3.74)	0.016
Chronic pancreatitis	48 (4.7)	15 (1.8)	33 (18.1)	12.26 (6.50-23.12)	< 0.001
Pancreatic cancer	11 (1.1)	4 (0.5)	7 (3.9)	8.41 (2.44-29.04)	0.001
Previous acute pancreatitis	23 (2.2)	17 (2.0)	6 (3.3)	1.66 (0.65-4.27)	0.293
Upper GI surgery	49 (4.8)	33 (3.9)	16 (8.8)	2.37 (1.27-4.40)	0.006
Cholecystectomy	57 (5.6)	47 (5.6)	10 (5.5)	0.99 (0.49-1.99)	0.968
Bile acid malabsorption	111 (10.8)	94 (11.1)	17 (9.3)	1.03 (0.52-2.04)	0.938
Coeliac disease	15 (1.5)	13 (1.5)	2 (1.1)	0.71 (0.16-3.17)	0.654
CCF	13 (1.3)	8 (1.0)	5 (2.8)	2.95 (0.95-9.13)	0.060
CKD	38 (3.7)	25 (3.0)	13 (7.1)	2.52 (1.26-5.03)	0.009
Hyperparathyroidism	9 (0.9)	8 (1.0)	1 (0.6)	0.58 (0.07-4.64)	0.606
HIV	9 (0.9)	6 (0.7)	3 (1.7)	2.34 (0.58-9.45)	0.232
Haemochromatosis	3 (0.3)	3 (0.4)	0 (0)	-	-
PPI therapy1	425 (41.4)	316 (37.4)	109 (59.9)	2.50 (1.78-3.52)	< 0.001
Alcohol excess1
Ex-excess	108 (10.5)	70 (8.3)	38 (20.9)	3.24 (1.68-6.22)	0.001
Current excess	114 (11.1)	87 (10.3)	27 (14.8)	1.83 (1.13-2.97)	0.014
Smoking history1
Ex-smoker	261 (25.4)	207 (24.5)	54 (29.7)	1.55 (0.98-2.46)	0.061
Current smoker	176 (17.1)	132 (15.6)	44 (24.2)	2.00 (1.31-3.04)	0.001

¹Proportions and odds ratios derived from the pooled multiple imputation datasets. Ethnicity reference group is white ethnicity; Alcohol excess reference group is never excess; Smoking history reference group is never-smoker. IBD: Inflammatory bowel disease; GI: Gastrointestinal; CCF: Congestive heart failure; CKD: Chronic kidney disease; HIV: Human immunodeficiency virus; PPI: Proton pump inhibitor; FE1: Faecal elastase-1.

Table 2 Distribution of symptoms in the total cohort and by faecal elastase-1 result, and results from the univariable logistic regression analysis.

Symptom	Total cohort, n (%)	FE1 ≥ 200 μg/g, n (%)	FE1 < 200 μg/g, n (%)	OR (95%CI)	P value
Abdominal pain	567 (55.2)	476 (56.3)	91 (50.0)	0.77 (0.56-1.06)	0.112
Diarrhoea	671 (65.3)	545 (64.5)	126 (69.2)	1.23 (0.87-1.74)	0.231
Weight loss	392 (38.2)	308 (36.4)	84 (46.2)	1.49 (1.08-2.06)	0.015
Bloating	263 (25.6)	226 (26.7)	37 (20.3)	0.70 (0.47-1.03)	0.072
Nausea and vomiting	129 (12.6)	106 (12.5)	23 (12.6)	1.01 (0.62-1.63)	0.973
Steatorrhoea	95 (9.3)	64 (7.6)	31 (17.0)	2.51 (1.58-3.98)	< 0.001
Dyspepsia	86 (8.4)	71 (8.4)	15 (8.2)	0.98 (0.55-1.75)	0.943
Flatulence	61 (5.9)	55 (6.5)	6 (3.3)	0.49 (0.21-1.16)	0.103
Fatigue	21 (2.0)	19 (2.3)	2 (1.1)	0.48 (0.11-2.09)	0.331

FE1: Faecal elastase-1.

Table 3 Multiple imputation multivariable logistic regression analysis showing associations between exposure variables and pancreatic exocrine insufficiency

Variable	OR (95%CI)	P value
Demographics
Age	1.00 (0.99-1.01)	0.597
Sex
Male	1.18 (0.80-1.74)	0.399
Ethnicity
Asian	2.11 (1.30-3.42)	0.002
Black	1.22 (0.66-2.27)	0.524
Other	1.45 (0.88-2.38)	0.144
Comorbidities
Type 2 diabetes	1.84 (1.18-2.87)	0.007
Liver cirrhosis	0.96 (0.45-2.06)	0.924
Chronic pancreatitis	7.98 (3.95-16.15)	< 0.001
Pancreatic cancer	6.58 (1.67-25.98)	0.007
Upper GI surgery	2.62 (1.32-5.19)	0.006
CCF	1.67 (0.42-6.65)	0.466
CKD	1.71 (0.74-3.97)	0.212
PPI	1.87 (1.25-2.80)	0.002
Alcohol excess
Ex-excess	2.06 (0.94-4.51)	0.07
Current excess	1.56 (0.85-2.87)	0.152
Smoking history
Ex-smoker	1.02 (0.57-1.84)	0.949
Current smoker	1.33 (0.79-2.25)	0.287

Ethnicity reference group is white ethnicity; Alcohol excess reference group is never excess; Smoking history reference group is never-smoker. GI: Gastrointestinal; CCF: Congestive heart failure; CKD: Chronic kidney disease; PPI: Proton pump inhibitor.