Abstract
Aim To investigate the clinical features and prognosis in patients of hyperlipidemic acute pancreatitis with or without diabetes. Methods 157 patients with hypertriglyceridemic pancreatitis (HTGP) were included in this study. Patients with a previous history of diabetes were identified in the group of HTGP with diabetes (HTGPD), while patients without a history of diabetes were identified in the group of HTGP. The clinical characteristics and prognosis data of these patients in the two groups were analyzed. Results Multivariate Cox regression analysis showed that age, body mass index, glycated serum protein (GSP), and Acute Physiology and Chronic Health Evaluation (APACHE) II score were significantly associated with mortality in patients with HTGP. The mortality was significantly higher in the HTGPD group than in the HTGP group (p < 0.001). Compared to patients of HTGP, those of HTGPD had older age of onset, higher blood glucose levels, and higher GSP levels on admission. Electrocardiograms showed that patients of HTGPD had a significantly higher risk of heart ischemia than those of HTGP (p < 0.05). Patients of HTGPD had higher APACHE II scores than those of HTGP (p < 0.001). Single-factor analysis showed that higher triglyceride levels, GSP, LDL, and previous history of diabetes were associated with HTGP recurrence. Conclusions Clinicians should be alert to patients of HTGP with diabetes. Diabetes is an important risk factor for HTGP and hyperglycemia may affect the development and prognosis of HTGP.
Highlights
Patients with a previous history of diabetes were identified in the group of hypertriglyceridemic pancreatitis (HTGP) with diabetes (HTGPD), while patients without a history of diabetes were identified in the group of HTGP
Body mass index (BMI), Acute Physiology and Chronic Health Evaluation (APACHE) II score, bedside index for severity in Acute pancreatitis (AP) score, and computed tomography (CT) severity index score were calculated, the APACHE-II score was calculated during the first 24 h after admission; myocardial ischemia was identified on an electrocardiogram
The patients in the HTGP alone (HTGPA) group had a shorter time from first symptoms to admission, and most patients in this group went to the hospital for abdominal pain
Summary
Patients with type 2 diabetes are prone to suffer hypertriglyceridemia (HTG) and biliary calculi simultaneously [2]. The main risk factor for AP in China is biliary pancreatitis, while the rate of AP induced by HTG is increasing [3]. A Japanese observational study found an increased risk of acute pancreatitis in patients with type 2 diabetes mellitus [4]. If self-monitoring of blood glucose in patients with a long history of diabetes is poor, especially for glycated serum protein (GSP) and glycosylated hemoglobin A1c (HbA1c), the continuously high blood glucose can increase patients’ risk of suffering AP. Through evaluating the clinical features and prognosis in patients of hypertriglyceridemic pancreatitis with diabetes (HTGPD) in this study, we hope to provide certain evidence to guide HTGPD’s prevention and control
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