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Multicenter Study
. 2020 Jun;20(4):608-616.
doi: 10.1016/j.pan.2020.03.018. Epub 2020 Apr 10.

Hypertriglyceridemia-induced acute pancreatitis: A prospective, multicenter, international cohort analysis of 716 acute pancreatitis cases

Dóra Mosztbacher  1 , Lilla Hanák  2 , Nelli Farkas  3 , Andrea Szentesi  4 , Alexandra Mikó  5 , Judit Bajor  5 , Patrícia Sarlós  5 , József Czimmer  5 , Áron Vincze  5 , Péter Jenő Hegyi  2 , Bálint Erőss  2 , Tamás Takács  6 , László Czakó  6 , Balázs Csaba Németh  6 , Ferenc Izbéki  7 , Adrienn Halász  7 , László Gajdán  7 , József Hamvas  8 , Mária Papp  9 , Ildikó Földi  9 , Krisztina Eszter Fehér  9 , Márta Varga  10 , Klára Csefkó  10 , Imola Török  11 , Hunor Pál Farkas  12 , Artautas Mickevicius  13 , Elena Ramirez Maldonado  14 , Ville Sallinen  15 , János Novák  16 , Ali Tüzün Ince  17 , Shamil Galeev  18 , Barnabás Bod  19 , János Sümegi  20 , Petr Pencik  21 , Zsolt Dubravcsik  22 , Dóra Illés  6 , Szilárd Gódi  23 , Balázs Kui  6 , Katalin Márta  2 , Dániel Pécsi  2 , Péter Varjú  24 , Zsolt Szakács  2 , Erika Darvasi  25 , Andrea Párniczky  26 , Péter Hegyi  27 ; Hungarian Pancreatic Study Group
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Free article
Multicenter Study

Hypertriglyceridemia-induced acute pancreatitis: A prospective, multicenter, international cohort analysis of 716 acute pancreatitis cases

Dóra Mosztbacher et al. Pancreatology. 2020 Jun.
Free article

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.

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Conflict of interest statement

Declaration of competing interest The authors declare that the research was conducted in the absence of any conflict of interest.

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