Researchers at Semmelweis University analyzed data from 2244 patients with acute pancreatitis across 29 healthcare centers in 13 countries. Based on the patients’ weight and height, the researchers calculated their body mass index (BMI) and categorized them accordingly into different groups. The research team then examined how the disease progressed in cases of normal weight, overweight, and varying degrees of obesity.
According to the internationally accepted body mass index classification, the upper limit of normal weight for a person who is 180 centimeters tall is approximately 81 kilograms, while mild obesity begins at 97.2 kilograms. Even in this category, compared to patients of normal weight, the research shows that the odds of organ failure – a severe dysfunction of vital organs like the kidneys, lungs, or heart – were more than twice as high. The higher the degree of obesity, the higher these odds became. Furthermore, in cases of obesity, the odds of developing severe pancreatitis was significantly higher than for those of normal weight.
What is acute pancreatitis?
Acute pancreatitis occurs when digestive enzymes, instead of exerting their effects in the small intestine, become prematurely activated in the pancreas and damage its tissues, causing inflammation. The disease is most commonly triggered by gallstones or excessive alcohol consumption. This sudden-onset disease, typically accompanied by severe abdominal pain, affects approximately 5000 people annually in Hungary. Although the disease has a mild course in 70 percent of cases, the mortality rate in severe cases can reach 30 percent.
“Even in an asymptomatic state, people with overweight or obesity may have chronic low-grade inflammation. Therefore, when an unexpected disease strikes, their immune system may respond excessively, which may worsen their prognosis,” explained Andrea Szentesi, the first author of the study, a PhD supervisor at Semmelweis University’s Doctoral College and researcher at the University of Pécs, regarding a potential cause of the disease’s severity.
The expert added that the chances of recovery might be further reduced by other comorbidities linked to overweight – such as circulatory disorders – and by physical problems arising from severe obesity, such as shortness of breath. She highlighted that overcoming the factors contributing to a more severe course of the disease, such as obesity or excessive alcohol consumption, might also require adopting a health-conscious lifestyle. However, weight loss is extremely difficult for many patients.
“Perhaps the most important message for patients is that obesity may worsen outcomes not only in the long term, but also in the event of a suddenly developing acute disease. For this reason, even a gradual or smaller weight loss might be effective,” said Dr. Péter Hegyi, the last author of the study, Director of the Institute of Pancreatic Diseases and the Centre for Translational Medicine at Semmelweis University.
The researchers also highlight the importance of follow-up examinations after hospital treatment. Since the inflammation may later lead to diabetes or digestive problems, the coordinated work of professionals, including doctors, dietitians, and psychologists, plays an important role in the early detection and treatment of these complications.
However, the investigations do not stop at analyzing the degree of obesity. In an ongoing study, the researchers are already investigating how other lifestyle factors, such as sleep quality, stress, nutrition, or physical activity, might influence the outcome of acute pancreatitis.
Bálint Győrfi, Róbert Cseszregi
Photo: Boglárka Zellei – Semmelweis University
Cover image: iStock by Getty Images / Warawan Tongsri
