Diabetes and Younger Age Are Vital and Independent Risk Factors for Acute Pancreatitis in Patients with Severe Hypertriglyceridemia.

Qiang Li,Chaoqun Hou,Min Tu,Yunpeng Peng,Feng Guo,Xiaole Zhu,Chenyuan Shi,Yi Miao,Dongya Huang,Kai Zhang

doi:10.1155/2019/2620750

Abstract

Background. The incidence of hypertriglyceridemia-induced acute pancreatitis (HIAP) is increasing worldwide, and now it is the third leading cause of acute pancreatitis in the United States. But, there are only 5% of patients with severe hypertriglyceridemia (>1000 mg/dl) which might generate acute pancreatitis. In order to explore which part of the patients is easy to develop into pancreatitis, a case-control study was performed by us to consider which patient population tend to develop acute pancreatitis in patients with severe hypertriglyceridemia. To perform a retrospective case-control study, we identified severe hypertriglyceridemia patients without AP (HNAP) and with HIAP with a fasting triglyceride level of >1000 mg/dl from The First Affiliated Hospital of Nanjing Medical University during January 1, 2014, to December 31, 2016. Baseline patient characteristics, comorbidities, and risk factors were recorded and evaluated by the univariate and multivariate logistic regression analysis for HIAP and HNAP patients. A total of 124 patients with severe hypertriglyceridemia were included in this study; of which, 62 patients were in the HIAP group and 62 were in the HNAP group. Univariate logistic regression analysis showed that there was no gender difference in both groups; however, there were more younger patients in the HIAP group than in the HNAP group ( value < 0.001), and the HIAP group had low level of high-density lipoprotein compared to the HNAP group (). Meanwhile, the presence of pancreatitis was associated with higher level of glycemia and a history of diabetes (). Multivariate logistic regression analysis indicated that a history of diabetes and younger age were independent risk factors for acute pancreatitis in patients with severe hypertriglyceridemia. Uncontrolled diabetes and younger age are potential risk factors in patients with severe hypertriglyceridemia to develop acute pancreatitis.

Highlights

Acute pancreatitis (AP) is a potentially life-threatening acute inflammatory disease of the pancreas
124 patients with severe hypertriglyceridemia were included in this study; of which, 62 patients were in the hypertriglyceridemia-induced acute pancreatitis (HIAP) group and 62 patients were in the hypertriglyceridemia patients without AP (HNAP) group (Figure 1)
Baseline Characteristics of the Study Sample. e baseline characteristics of hypertriglyceridemia patients with or without AP are summarized in Table 1; a total of 124 patients with severe hypertriglyceridemia were included in this study

Summary

Introduction

Acute pancreatitis (AP) is a potentially life-threatening acute inflammatory disease of the pancreas. It is characterized by a systemic inflammatory response, with a growing number of hospitalizations each year, and it is associated with a mortality ranging from 3 to 30% in the world [1, 2]. It is reported that hypertriglyceridemia affects approximately one-quarter of the United States (US) population [8]. According to the Guidelines of the American College of Gastroenterology and the Endocrine Society, high TG levels (≥1000 mg/dL) should be considered as a risk factor for developing acute pancreatitis [10, 11].

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Discussion

Conclusion