Lipid Profile Changes and Importance of Low Serum α-Lipoprotein Fraction (High-Density Lipoprotein) in Cases With Acute Pancreatitis

Bugdaci, Mehmet Sait; Sokmen, Mehmet; Zuhur, Sayid Shafi

doi:10.1097/mpa.0b013e3182211bbf

Cited by 22 publications

(29 citation statements)

References 34 publications

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“…When combined with lower lipoprotein lipase activity, this might lead to higher serum concentrations of triglycerides [25], a tendency observed in this study also. Bugdaci et al [26] have previously studied the lipid profile in patients with acute pancreatitis. They reported an association with low serum HDL cholesterol concentration and longer hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Serum Lipid Levels Are Associated with the Severity of Acute Pancreatitis

Khan

Nordback

Sand³

2013

Digestion

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Background/Aims: Serum lipid concentrations react during acute disease. We sought to measure changes in the serum lipid profile during acute pancreatitis and ascertain whether these changes were associated with the severity of the disease. Methods: A total of 233 patients (71% male, median age 48 years) hospitalized for acute pancreatitis were included in the study. The most common etiology for acute pancreatitis was alcohol (n = 131, 56%), followed by biliary (n = 48, 21%) and idiopathic pancreatitis (n = 36, 16%). Serum lipid levels were measured enzymatically. We analyzed samples obtained during the first days of hospitalization and later follow-up samples to measure changes during the course of the disease. Results: We report profound changes in the serum lipid concentrations during acute pancreatitis. Serum total cholesterol, high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol concentrations measured within 2 days of admission (n = 203) were significantly lower in patients who developed severe pancreatitis (3.20 vs. 3.80 mmol/l, p = 0.001; 0.72 vs. 1.05 mmol/l, p < 0.000, and 1.60 vs. 2.14 mmol/l, p < 0.000, respectively). Low serum total cholesterol, HDL cholesterol and LDL cholesterol concentrations were moreover associated with in-hospital mortalities and longer hospitalization (p < 0.05). In the subgroup analysis, the findings remained statistically significant in patients with alcohol-induced acute pancreatitis. Conclusion: Levels of serum total cholesterol, HDL cholesterol and LDL cholesterol are significantly lower in patients with severe acute pancreatitis and are associated with longer hospitalization.

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Section: Discussionmentioning

confidence: 99%

Serum Lipid Levels Are Associated with the Severity of Acute Pancreatitis

Khan

Nordback

Sand³

2013

Digestion

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“…Bugdaci et al suggested two possible pathways. 40 First, they found that patients with acute pancreatitis had mild elevation of thyroid-stimulating hormone, possibly due to the systemic inflammatory state in acute pancreatitis. Transient elevation of thyroid-stimulating hormone could increase the level of triglycerides.…”

Section: Dyslipidemiamentioning

confidence: 99%

“…9,37 Levels of high-density lipoprotein (HDL) during acute pancreatitis are low and directly associated with the severity of disease. 40 Elevation of triglycerides is associated with low HDL levels. The theory proposed is that the inflammatory state in acute pancreatitis increases triglyceride levels and suppresses HDL levels.…”

Section: Dyslipidemiamentioning

confidence: 99%

“…Second, they proposed that the low HDL levels reduce lipoprotein lipase activity, leading to decreased degradation of triglycerides. 40 Treatment of dyslipidemia via elevation of HDL levels may contribute to recovery from an acute attack through an anti-inflammatory and antioxidant effect. 40 There are no published data investigating whether any particular HDL level can prevent future attacks.…”

Section: Dyslipidemiamentioning

confidence: 99%

“…It was also observed that adverse outcomes in patients with dyslipidemia were seen in hypertriglyceridemia, even though past studies did not see this relationship. 39,40 In cases of acquired hypertriglyceridemia, patients with a pre-existing lipid abnormality can develop pancreatitis in the setting of a secondary factor such as poorly controlled diabetes, alcohol use, or intake of medication such as estrogens and beta-blockers. 37 Control of triglyceride levels can prevent additional attacks of pancreatitis, specifically if levels are less than 1000 mg/dL.…”

Section: Dyslipidemiamentioning

confidence: 99%

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Nutritional advice for prevention of acute pancreatitis: review of current opinion

Lowe¹,

Sevilla²

2012

NDS

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Pancreatitis is inflammation of the pancreas that can be acute and self-limiting or, in a small percentage of patients, recurrent. Patients with recurrent episodes of acute pancreatitis (RAP) often progress to chronic pancreatitis. Pancreatitis in all forms causes significant economic and social burdens. Prevention of RAP may decrease those burdens and halt progression to chronic disease. Unfortunately, no therapy has proven effective at altering the course of RAP. While enteral nutritional therapy plays an important role in the treatment of acute pancreatitis during episodes, nutritional advice provided to patients in an attempt to prevent recurrent episodes has not proven effective in most cases. Discontinuing alcohol consumption and treating dyslipidemia with diet and medication can help patients with these issues. In patients whose pancreatitis is associated with celiac disease or eosinophilic gastroenteritis, a gluten-free diet and avoidance of food allergens can be effective in stopping RAP. Advice to take pancreatic enzyme replacement therapy, lose weight, control diabetes, decrease dietary sucrose, decrease dietary fat or avoid monosodium glutamate has little to no evidence of efficacy. Some studies suggest that an antioxidant cocktail may decrease the frequency of RAP and the intensity of chronic pain, but the evidence is weak. Nutritional therapy may have a role in the treatment of patients with RAP. At present, there are no clear guidelines for nutritional advice to give these patients. More studies are needed to identify nutritional interventions that will benefit patients with RAP.

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