Relationship between Plasma Triglyceride Level and Severity of Hypertriglyceridemic Pancreatitis

Abstract

BackgroundHypertriglyceridemia is the third most common cause of acute pancreatitis, but whether the level of triglyceride (TG) is related to severity of pancreatitis is unclear.AimTo evaluate the effect of TG level on the severity of hypertriglyceridemic pancreatitis (HTGP).DesignRetrospective cohort study.MethodsWe reviewed the records of 144 patients with HTGP from 1999 to 2013 at Tri-Service General Hospital. Patients with possible etiology of pancreatitis, such as gallstones, those consuming alcohol or drugs, or those with infections were excluded. The classification of severity of pancreatitis was based on the revised Atlanta classification. We allocated the patients into high-TG and low-TG groups based on the optimal cut-off value (2648 mg/dL), which was derived from the receiver operating characteristic (ROC) curve between TG level and severity of HTGP. We then compared the clinical characteristics, pancreatitis severity, and mortality rates of the groups.ResultsThere were 66 patients in the low-TG group and 78 patients in the high-TG group. There was no significant difference in the age, sex ratio, body mass index, and comorbidity between the 2 groups. The high-TG group had significantly higher levels of glucose (P = 0.022), total cholesterol (P = 0.002), and blood urea nitrogen (P = 0.037), and lower levels of sodium (P = 0.003) and bicarbonate (P = 0.002) than the low-TG group. The incidences of local complication (P = 0.002) and severe and moderate form of pancreatitis (P = 0.004) were significantly higher in the high-TG group than in the low-TG group. The mortality rate was higher in the high-TG group than in the low-TG group (P = 0.07).ConclusionsHigher TG level in patients with HTGP may be associated with adverse prognosis, but randomized and prospective studies are needed in the future verify this relationship.

Comparison of bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity of hyperlipidemic acute pancreatitis(HLAP)

“…Besides, the severe degree of fsignificantly higher than MAP group (13.1±8.2) mmol/L. Consistently, an analysis carried by Wang et al [11] indicated that when TG > 20.0mmol/L, MSAP and SAP patients accounted for 63.1%, which was also greatly higher than MAP petients. Oh et al [12] and Yadav et al [13] believed that the occurrence and mortality rate of AP will be reduced when TG is controlled under 5.65mmom/L.…”

Elevated triglycerides on admission positively correlate with the severity of hypertriglyceridaemic pancreatitis

“…A retrospective study of 224 patients with HTG‐AP showed that incidence of SAP in patients with TG levels >11.3 mmol/L (1000 mg/dL) was higher as compared with patients with TG levels of 5.65‐11.3 mmol/L (500‐1000 mg/dL) . Among AP patients with TG >11.3 mmol/L (1000 mg/dL), Wang et al reported statistically significant higher incidence of local complications, moderate to severe pancreatitis and ≥3 organ failures in patients with high TG levels (>29.9 mmol/L [2648 mg/dL]) as compared with the group with low TG levels (11.3‐29.9 mmol/L [1000‐2648 mg/dL]) . However, not all studies have shown a consistent difference in the clinical course by the level of serum TG .…”

Hypertriglyceridemia induced acute pancreatitis in pregnancy: Learning experiences and challenges of a Case report

“…Hypertriglyceridemia and pancreatitis due to it is not very common in pregnancy but can lead to severe complication and maternal and fetal morbidity and mortality if not diagnosed and treated timely. About 1-7% [9] of pancreatitis during pregnancy are caused due to hypertriglyceridemia and it is third common cause of pancreatitis during pregnancy after gall stone and alcoholic pancreatitis. Gestational pancreatitis in about 56% of patients is attributed to hypertriglyceridemia [9].…”

“…About 1-7% [9] of pancreatitis during pregnancy are caused due to hypertriglyceridemia and it is third common cause of pancreatitis during pregnancy after gall stone and alcoholic pancreatitis. Gestational pancreatitis in about 56% of patients is attributed to hypertriglyceridemia [9].…”