Abstract
The aim of the study is to evaluate the clinical characteristics of patients with hypertriglyceride associated acute pancreatitis. A single-center observational study of a series of cases was performed on the basis of the Kyiv Department of Surgery for Liver, Pancreas and Bile Tracts named after V.S. Zemskov in the period from 2018 to 2019. Investigation includes patients with acute pancreatitis and hypertriglyceridemia (the triglycerides level is more than 1.7 mmol/l). Exclusion criteria: patients with acute pancreatitis with normal triglyceride levels, patients with acute pancreatitis with elevated triglycerides, that have not been treated enough. All patients were evaluated by Charlson index of comorbidity, body mass index, alcohol history, relapses and severity of disease. All patients were monitored throughout inpatient treatment, from hospitalization to discharge to home or death. The end point of the study was the discharge of the patient to home after the elimination of the manifestations and complications of acute pancreatitis or death of the patient. The 234 patients who were hospitalized and treated with a diagnosis of acute pancreatitis, 27 patients had hypertriglyceridemia and 3 of them were excluded from the study. The study involved 24 patients. Therefore, the frequency of acute pancreatitis associated with high triglycerides was 11.5% (27/234), with the average level of triglyceridemia was 10.1 ± 2.4 mmol / l (range 5.8 - 13.6 mmol / l) , 75% of patients (18/24) had moderate hypertriglyceridemia (2.3 - 11.2 mmol / l), 25% (6/24) - severe (11.2 - 22.4 mmol / l) . The median age was 32 years (quarterly interval 31.5 - 35 years). There were 18 men (75%) and 6 women (25%). Alcohol-induced pancreatitis was observed in 17 (70.8%) patients with hypertrtiglyceridemia. The median body mass index is 28.9 kg / m 2. Normal weight was 33% (8/24) patients, excessive - 25% (6/24), obesity I stage - 29% (7/24) obesity II stage - 8% (2/24) obesity III stage - 4% (1/24). The Charlson comorbidity index ranged from 0 to 5 points, in 1 patient it was 5 points, in 3 patients - 2 points, in 3 patients - 1 point. Diabetes mellitus were in 25% of patients (6 /24), two of them was diagnosed at first. Recurrent cases of disease were in 58.3% of patients (14 /24), 10 of 14 had a history of two cases of acute pancreatitis. In 71% (17 /24) observed a light stage of the disease, 25% (6 /24) - pancreatitis medium degree of severity and in 4% (1 /24) of the patient severe pancreatitis. Mortality was 4%. Conclusions. The frequency of hypertriglyceride-associated acute pancreatitis is 11.5%. In light, moderate and severe pancreatitis, the average degree of hypertriglyceridemia (blood triglycerides 2.3 -11.2mmol/l) was prevailed. Hypertriglyceride-associated acute pancreatitis has no specific complications, but has a tendency to recurrence. Patients with hypertriglyceridemia need constant laboratory monitoring (determination of triglycerides), pharmacological therapy and follow-up to prevent the development of acute pancreatitis
Highlights
Acute pancreatitis (AP) remains an urgent problem of surgical pancreatology
Detection and elimination of the cause of the disease have a positive effect on the outcome of treatment of patients with AP (Dronov OI, Kovalskaya IO, Gorlach AI, Lubenets TV 2019) Hypertriglyceridemia is proved and is the one of the major ‘s reasons for AP development. (Balachandra, S.,et al 2006) Hypertriglyceride-associated pancreatitis is on the third place of AP and has 5 - 10% of alcoholic and biliary genesis. (Pothoulakis I.,et al 2020a) (De Pretis N., Amodio A. and Frulloni L. 2018a) Hypertriglyceridemia - is raising of triglycerides level (TG) in the blood serum with a value of 1.7 mmol / L or more
There were 234 patients who were hospitalized and treated with a diagnosis of AP during this period, hypertriglyceridemia had 27 patients (11.5%), 3 patients were excluded from the study due to refusal of treatment and inability for definitive analyze its results
Summary
Acute pancreatitis (AP) remains an urgent problem of surgical pancreatology. The results of its treatment depend on the severity of the disease, which depends on various factors not directly related to the disease, but on the principle of mutual abuse is involved in shaping the body’s response to pancreatic lesions. Detection and elimination of the cause of the disease have a positive effect on the outcome of treatment of patients with AP (Dronov OI, Kovalskaya IO, Gorlach AI, Lubenets TV 2019) Hypertriglyceridemia is proved and is the one of the major ‘s reasons for AP development. (Balachandra, S.,et al 2006) Hypertriglyceride-associated pancreatitis is on the third place of AP and has 5 - 10% of alcoholic and biliary genesis. According to the Frederickson’s classification primary (genetic) lipid metabolism abnormalities lead to elevated TG levels lead to lipoproteinemia IV (endogenous hyperlipidemia) and V (familial chylomicronemic syndrome) (Fredrickson D.S. 1965) Alcohol consumption, obesity, insulin resistance, oral estrogen intake are secondary factors in increasing blood TG levels Clinical recognition of hypertriglyceride-associated AP is important to identify the group of patients with adverse factors associated with impaired lipid metabolism. The aim of our study was to characterize the clinical course of hypertriglyceride-associated AP and to identify hypotheses for further research
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
