Abstract
BackgroundWhat kind of patients with hypertriglyceridemic acute pancreatitis (HLAP) might benefit from plasmapheresis (PP) remains unknown. The objective of this study is to determine the predict function of total cholesterol (TC) on the Triglyceride (TG)-lowing effect in patients on either non-PP or PP therapy.MethodsPatients were categorized into high total cholesterol (HTC)/low total cholesterol (LTC) groups based on TC level of 12.4 mmol/L. The primary outcome was TG reduction to below 500 mg/dL within 48 h. Linear mixed-effect model and logistic regression analyses were used to assess the association of TC level and TG-lowing efficacy in different therapy groups.ResultsCompared with LTC group, patients with HTC showed more severe imaging manifestations (p < 0.001) and higher APACH II scores (p = 0.036). Deaths occurred only in HTC groups. Significant interaction of time sequence with the 2 TGs-lowing therapy groups on TG level was only found in HTC group (p < 0.001). In patients with elevated TC level, primary outcome occurred in 66.67% of patients in the PP group, and 27.91% in the non-PP group. After adjustment for age, gender, CT grade and APACH II score, the odd ratio remain significant (OR 5.47, 95% confidence interval [CI] 1.84–16.25, p = 0.002). Furthermore, in patients with lower TC level, no significant difference was found in primary outcome between PP group and non-PP group (81.25% versus 62.30%, adjusted OR 2.05; 95% CI 0.45–9.40; p = 0.353).ConclusionsTC could be a potential biomarker to predict the effects of TG-lowing therapy in patients with HLAP.
Highlights
What kind of patients with hypertriglyceridemic acute pancreatitis (HLAP) might benefit from plasmapheresis (PP) remains unknown
Some studies report that PP can remove triglycerides (TGs) and chylomicron from circulation drastically within hours [8], while a recent retrospective study found that PP therapy had no additional TG-lowering effects
Organ dysfunction occurred in 20% of all patients. 67.3% and 56.0% patients were treated with insulin and heparin for reducing plasma TGs, respectively
Summary
What kind of patients with hypertriglyceridemic acute pancreatitis (HLAP) might benefit from plasmapheresis (PP) remains unknown. The objective of this study is to determine the predict function of total cholesterol (TC) on the Triglyceride (TG)-lowing effect in patients on either non-PP or PP therapy. Acute pancreatitis (AP) is a clinically common lifethreatening disease, and its incidence is increasing worldwide [1]. Some studies report that PP can remove triglycerides (TGs) and chylomicron from circulation drastically within hours [8], while a recent retrospective study found that PP therapy had no additional TG-lowering effects [9] What’s more, many studies have found that PP does not reduce mortality rates among patients with HLAP [10, 11]. PP requires special treatment equipment, is expensive, and involves some risks, such as allergy, bleeding and infection [12]
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