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. 2021 Jul 18;20(1):72.
doi: 10.1186/s12944-021-01488-8.

The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

Robert J Sanchez  1 , Wenzhen Ge  1 , Wenhui Wei  1 , Manish P Ponda  1 , Robert S Rosenson  2
Affiliations

The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

Robert J Sanchez et al. Lipids Health Dis. .

Abstract

Background: This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels.

Methods: Data were obtained from IQVIA's US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis.

Results: In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08-0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1-34.9%).

Conclusion: The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.

Keywords: Acute pancreatitis; Hypertriglyceridemia; Recurrent acute pancreatitis; Susceptibility threshold; Triglycerides.

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Conflict of interest statement

R. J. Sanchez, W. Ge, W. Wei, and M. Ponda are employees of and stockholders in Regeneron Pharmaceuticals, Inc. R. S. Rosenson has received research grants through his institution from Amgen, Novartis, and Regeneron Pharmaceuticals, Inc.; serves on advisory boards for Amgen, Amyrt, C5, CVS Caremark, Novartis, and 89 Bio; is a speaker (non-promotional) for Amgen, Kowa, and Regeneron; receives royalties from Wolters Kluwer (UpToDate); and has stock ownership in MediMergent, LLC.

Figures

Fig. 1
Fig. 1
Overview of IR of AP by circulating TG concentration and history of hospitalization for AP. Abbreviations: AP acute pancreatitis, CI confidence interval, IR incidence rate, TG triglyceride
See this image and copyright information in PMC

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