Ruwen Zhang1, Lihui Deng1, Tao Jin1, Ping Zhu1, Na Shi1, Kun Jiang1, Lan Li1, Xinmin Yang1, Jia Guo1, Xiaonan Yang1, Tingting Liu1, Rajarshi Mukherjee2, Vikesh K Singh3, John A Windsor4, Robert Sutton2, Wei Huang5, Qing Xia6. 1. Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital of Sichuan University, Chengdu, China. 2. Liverpool Pancreatitis Research Group, Royal Liverpool University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool, UK. 3. Pancreatitis Centre, Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, USA. 4. Department of Surgery, University of Auckland, Auckland, New Zealand. 5. Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital of Sichuan University, Chengdu, China. Electronic address: dr_wei_huang@scu.edu.cn. 6. Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital of Sichuan University, Chengdu, China. Electronic address: xiaqing@medmail.com.cn.
Abstract
BACKGROUND: The level of hypertriglyceridaemia (HTG) at which the risk of acute pancreatitis (AP) increases and the impact of HTG on AP attributable to other aetiologies remains unclear. METHODS: We compared clinical outcomes of patients admitted within 48 h of the onset of abdominal pain from a first episode of AP and admission serum triglyceride levels of either <5.65 mmol/l (<500 mg/dl) or ≥5.65 to <11.3 mmol/l (moderate HTG) or ≥11.3 mmol/l (≥1000 mg/dl, severe HTG). RESULTS: Among a cohort of 1,233 patients with AP there were significant progressive increases in all major deleterious clinical outcomes including mortality (all Ptrend < 0.05) that were directly dependent on admission triglyceride levels. Outcomes were improved by earlier presentation (<24 h compared to 24-48 h from abdominal pain onset). Patients with severe HTG and a concomitant aetiology (n = 68) had significantly more persistent organ failure, pancreatic necrosis and longer hospital stays (P < 0.05) than those with severe HTG alone (n = 206). CONCLUSIONS: There appears to be an association between HTG grade and the severity of AP. Severe HTG significantly increased the severity of AP, over AP attributable to other aetiologies. Moderate as well as severe HTG can be used as a criterion for the diagnosis of HTG-associated AP.
BACKGROUND: The level of hypertriglyceridaemia (HTG) at which the risk of acute pancreatitis (AP) increases and the impact of HTG on AP attributable to other aetiologies remains unclear. METHODS: We compared clinical outcomes of patients admitted within 48 h of the onset of abdominal pain from a first episode of AP and admission serum triglyceride levels of either <5.65 mmol/l (<500 mg/dl) or ≥5.65 to <11.3 mmol/l (moderate HTG) or ≥11.3 mmol/l (≥1000 mg/dl, severe HTG). RESULTS: Among a cohort of 1,233 patients with AP there were significant progressive increases in all major deleterious clinical outcomes including mortality (all Ptrend < 0.05) that were directly dependent on admission triglyceride levels. Outcomes were improved by earlier presentation (<24 h compared to 24-48 h from abdominal pain onset). Patients with severe HTG and a concomitant aetiology (n = 68) had significantly more persistent organ failure, pancreatic necrosis and longer hospital stays (P < 0.05) than those with severe HTG alone (n = 206). CONCLUSIONS: There appears to be an association between HTG grade and the severity of AP. Severe HTG significantly increased the severity of AP, over AP attributable to other aetiologies. Moderate as well as severe HTG can be used as a criterion for the diagnosis of HTG-associated AP.
Authors: Peter Szatmary; Ankur Arora; Michael Godwin Thomas Raraty; Declan Francis Joseph Dunne; Ryan David Baron; Christopher Michael Halloran Journal: Gastroenterology Date: 2020-06-01 Impact factor: 22.682
Authors: Lan Li; Tao Jin; Si Wen; Na Shi; Ruwen Zhang; Ping Zhu; Ziqi Lin; Kun Jiang; Jia Guo; Tingting Liu; Anthony Philips; Lihui Deng; Xiaonan Yang; Vikesh K Singh; Robert Sutton; John A Windsor; Wei Huang; Qing Xia Journal: Dig Dis Sci Date: 2020-01-07 Impact factor: 3.199
Authors: Savio George Barreto; Aida Habtezion; Anna Gukovskaya; Aurelia Lugea; Christie Jeon; Dhiraj Yadav; Peter Hegyi; Viktória Venglovecz; Robert Sutton; Stephen J Pandol Journal: Gut Date: 2020-09-24 Impact factor: 23.059
Authors: Tao Jin; Lan Li; Lihui Deng; Si Wen; Ruwen Zhang; Na Shi; Ping Zhu; Lan Lan; Ziqi Lin; Kun Jiang; Jia Guo; Tingting Liu; Anthony Philips; Xiaonan Yang; Vikesh K Singh; Robert Sutton; John A Windsor; Wei Huang; Qing Xia Journal: JGH Open Date: 2020-03-13