Hypertriglyceridemia-induced acute pancreatitis: A prospective, multicenter, international cohort analysis of 716 acute pancreatitis cases
Dóra Mosztbacher, Lilla Hanák, Nelli Farkas, Andrea Szentesi, Alexandra Mikó, Judit Bajor, Patrícia Sarlós, József Czimmer, Áron Vincze, Péter Jenő Hegyi, Bálint Erőss, Tamás Takács, László Czakó, Balázs Csaba Németh, Ferenc Izbéki, Adrienn Halász, László Gajdán, József Hamvas, Mária Papp, Ildikó Földi, Krisztina Eszter Fehér, Márta Varga, Klára Csefkó, Imola Török, Hunor Pál Farkas, Artautas Mickevicius, Elena Ramirez Maldonado, Ville Sallinen, János Novák, Ali Tüzün Ince, Shamil Galeev, Barnabás Bod, János Sümegi, Petr Pencik, Zsolt Dubravcsik, Dóra Illés, Szilárd Gódi, Balázs Kui, Katalin Márta, Dániel Pécsi, Péter Varjú, Zsolt Szakács, Erika Darvasi, Andrea Párniczky, Péter Hegyi, Hungarian Pancreatic Study Group, Dóra Mosztbacher, Lilla Hanák, Nelli Farkas, Andrea Szentesi, Alexandra Mikó, Judit Bajor, Patrícia Sarlós, József Czimmer, Áron Vincze, Péter Jenő Hegyi, Bálint Erőss, Tamás Takács, László Czakó, Balázs Csaba Németh, Ferenc Izbéki, Adrienn Halász, László Gajdán, József Hamvas, Mária Papp, Ildikó Földi, Krisztina Eszter Fehér, Márta Varga, Klára Csefkó, Imola Török, Hunor Pál Farkas, Artautas Mickevicius, Elena Ramirez Maldonado, Ville Sallinen, János Novák, Ali Tüzün Ince, Shamil Galeev, Barnabás Bod, János Sümegi, Petr Pencik, Zsolt Dubravcsik, Dóra Illés, Szilárd Gódi, Balázs Kui, Katalin Márta, Dániel Pécsi, Péter Varjú, Zsolt Szakács, Erika Darvasi, Andrea Párniczky, Péter Hegyi, Hungarian Pancreatic Study Group
Abstract
Background: Hypertriglyceridemia is the third most common cause of acute pancreatitis (AP). It has been shown that hypertriglyceridemia aggravates the severity and related complications of AP; however, detailed analyses of large cohorts are contradictory. Our aim was to investigate the dose-dependent effect of hypertriglyceridemia on AP.
Methods: AP patients over 18 years old who underwent triglyceride measurement within the initial three days were included into our cohort analysis from a prospective international, multicenter AP registry operated by the Hungarian Pancreatic Study Group. Data on 716 AP cases were analyzed. Six groups were created based on the highest triglyceride level (<1.7 mmol/l, 1.7-2.19 mmol/l, 2.2-5.59 mmol/l, 5.6-11.29 mmol/l, 11.3-22.59 mmol/l, ≥22.6 mmol/l).
Results: Hypertriglyceridemia (≥1.7 mmol/l) presented in 30.6% of the patients and was significantly and dose-dependently associated with younger age and male gender. In 7.7% of AP cases, hypertriglyceridemia was considered as a causative etiological factor (≥11.3 mmol/l); however, 43.6% of these cases were associated with other etiologies (alcohol and biliary). Hypertriglyceridemia was significantly and dose-dependently related to obesity and diabetes. The rates of local complications and organ failure and maximum CRP level were significantly and dose-dependently raised by hypertriglyceridemia. Triglyceride above 11.3 mmol/l was linked to a significantly higher incidence of moderately severe AP and longer hospital stay, whereas triglyceride over 22.6 mmol/l was significantly associated with severe AP as well.
Conclusion: Hypertriglyceridemia dose-dependently aggravates the severity and related complications of AP. Diagnostic workup for hypertriglyceridemia requires better awareness regardless of the etiology of AP.
Keywords: Acute pancreatitis; Cohort; Etiology; Hypertriglyceridemia; Severity.
Conflict of interest statement
Declaration of competing interest The authors declare that the research was conducted in the absence of any conflict of interest.
Copyright © 2020 IAP and EPC. Published by Elsevier B.V. All rights reserved.
Source: PubMed