Lipid metabolism for predicting the recurrence of hypertriglyceridemic acute pancreatitis

Abstract

Rationale and objectives: To investigate the predictive value of lipid metabolism in predicting the recurrence of hypertriglyceridemic acute pancreatitis (HTG-AP).

Materials and methods: A total of 892 patients were admitted to our hospital for acute pancreatitis (AP) from January 2017 to December 2020, of whom 198 diagnosed with HTG-AP were enrolled in this retrospective study. Demographic information, length of stay, smoking index, alcohol abuse, necrosis, severity, baseline lipid metabolism and other blood biochemical indicators were recorded. The risk factors of recurrence were evaluated using univariate and multivariate Cox proportional risk analyses, and the cumulative recurrence-free survival rate of patients were calculated using Kaplan Meier method and the differences between groups were compared using the log-rank test.

Results: Univariate and multivariate analysis showed that triglyceride (hazard ratio, 2.421; 95% CI, 1.152-5.076; P = 0.020), non high-density lipoprotein (hazard ratio, 4.630; 95% CI, 1.692-12.658; P = 0.003) and apolipoprotein A1 (hazard ratio, 1.735; 95% CI, 1.093-2.754; P = 0.019) were important predictors for recurrence of HTG-AP. Subsequently, patients were divided into four groups according to the cut off values of triglyceride, non high-density lipoprotein and apolipoprotein A1. It was found that the cumulative recurrence-free survival rate of patients in highest-risk group or high-risk group was significantly lower than that of medium-risk group (P < 0.001, P = 0.003) or low risk group (P < 0.001).

Conclusion: Serum triglycerides, non high-density lipoprotein and apolipoprotein A1 are independent predictors of recurrence in HTG-AP patients, which can provide reference for individualized treatment and prevention of recurrence in HTG-AP patients.

Keywords: Acute pancreatitis; Hypertriglyceridemia; Lipid metabolism; Recurrence.

Fig. 1

Survival curves by Kaplan-Meier analyses, comparing the cumulative recurrence-free survival rate between patients with TG ≥ 11.70 mmol/L and TG ＜ 11.70 mmol/L.

Fig. 2

Survival curves by Kaplan-Meier analyses, comparing the cumulative recurrence-free survival rate between patients with NHDL ≥4.90 mmol/L and NHDL <4.90 mmol/L.

Fig. 3

Survival curves by Kaplan-Meier analyses, comparing the cumulative recurrence-free survival rate between patients with Apo A1 ≥0.76 g/L and Apo A1 < 0.76 g/L.

Fig. 4

Survival curves by Kaplan-Meier analyses, comparing the cumulative recurrence-free survival rate among the highest-risk group, high-risk group, medium-risk group, and low-risk group.