Ioannis Pothoulakis1, Pedram Paragomi2, Livia Archibugi3, Marie Tuft2, Rupjyoti Talukdar4, Rakesh Kochhar5, Mahesh Kumar Goenka6, Aiste Gulla7, Vikesh K Singh8, Jose A Gonzalez9, Miguel Ferreira10, Sorin T Barbu11, Tyler Stevens12, Haq Nawaz13, Silvia C Gutierrez14, Narcis O Zarnescu15, Jeffrey Easler16, Konstantinos Triantafyllou17, Mario Pelaez-Luna18, Shyam Thakkar19, Carlos Ocampo20, Enrique de-Madaria21, Bechien U Wu22, Gregory A Cote23, Gong Tang2, Georgios I Papachristou24, Gabriele Capurso3. 1. University of Pittsburgh Medical Center, Pittsburgh, PA, USA; MedStar Washington Hospital Center, Washington, DC, USA. 2. University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 3. Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan, Italy; Digestive and Liver Disease Unit, Sant Andrea Hospital, Rome, Italy. 4. Asian Gastroenterology Institute, Hyderabad, India. 5. Postgraduate Institute of Medical Education and Research, Chandigarh, India. 6. Apollo Gleneagles Hospitals Kolkata, Kolkata, India. 7. Lithuanian University of Health Sciences, Kaunas, Lithuania. 8. John Hopkins Medical Institution, Baltimore, MD, USA. 9. Universidad Autónoma de Nueva León, Monterrey, Mexico. 10. Hospital Nacional de Itaguá, Itagua, Paraguay. 11. University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. 12. Cleveland Clinic Foundation, Cleveland, USA. 13. Eastern Maine Medical Center, Maine, Bangor, USA. 14. Hospital Nacional "Profesor Alejandro Posadas", Buenos Aires, Argentina. 15. University of Medicine and Pharmacy, Bucharest, Romania. 16. Indiana University School of Medicine, Indianapolis, IN, USA. 17. Attikon University General Hospital, Athens, Greece. 18. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán-Universidad Autónoma de Mexico, Mexico City, Mexico. 19. Allegheny General Hospital, Pittsburgh, PA, USA. 20. Hospital General de Argudos "Dr. Cosme Argerich", Buenos Aires, Argentina. 21. Investigación Sanitaria y Biomédica de Alicante (ISABIAL - Fundación FISABIO), Alicante, Spain. 22. Kaiser Permanente, Pasadena, CA, USA. 23. Medical University of South Carolina, Charleston, SC, USA. 24. University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: georgios.papachristou@osumc.edu.
Abstract
BACKGROUND: The clinical features and outcomes of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) are not well-established. OBJECTIVE: To evaluate the clinical characteristics of HTG-AP in an international, multicenter prospective cohort. METHODS: Data collection was conducted prospectively through APPRENTICE between 2015 and 2018. HTG-AP was defined as serum TG levels >500 mg/dl in the absence of other common etiologies of AP. Three multivariate logistic regression models were performed to assess whether HTG-AP is associated with SIRS positive status, ICU admission and/or moderately-severe/severe AP. RESULTS: 1,478 patients were included in the study; 69 subjects (4.7%) were diagnosed with HTG-AP. HTG-AP patients were more likely to be younger (mean 40 vs 50 years; p < 0.001), male (67% vs 52%; p = 0.018), and with a higher BMI (mean 30.4 vs 27.5 kg/m2; p = 0.0002). HTG-AP subjects reported more frequent active alcohol use (71% vs 49%; p < 0.001), and diabetes mellitus (59% vs 15%; p < 0.001). None of the above risk factors/variables was found to be independently associated with SIRS positive status, ICU admission, or severity in the multivariate logistic regression models. These results were similar when including only the 785 subjects with TG levels measured within 48 h from admission. CONCLUSION: HTG-AP was found to be the 4th most common etiology of AP. HTG-AP patients had distinct baseline characteristics, but their clinical outcomes were similar compared to other etiologies of AP.
BACKGROUND: The clinical features and outcomes of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) are not well-established. OBJECTIVE: To evaluate the clinical characteristics of HTG-AP in an international, multicenter prospective cohort. METHODS: Data collection was conducted prospectively through APPRENTICE between 2015 and 2018. HTG-AP was defined as serum TG levels >500 mg/dl in the absence of other common etiologies of AP. Three multivariate logistic regression models were performed to assess whether HTG-AP is associated with SIRS positive status, ICU admission and/or moderately-severe/severe AP. RESULTS: 1,478 patients were included in the study; 69 subjects (4.7%) were diagnosed with HTG-AP. HTG-APpatients were more likely to be younger (mean 40 vs 50 years; p < 0.001), male (67% vs 52%; p = 0.018), and with a higher BMI (mean 30.4 vs 27.5 kg/m2; p = 0.0002). HTG-AP subjects reported more frequent active alcohol use (71% vs 49%; p < 0.001), and diabetes mellitus (59% vs 15%; p < 0.001). None of the above risk factors/variables was found to be independently associated with SIRS positive status, ICU admission, or severity in the multivariate logistic regression models. These results were similar when including only the 785 subjects with TG levels measured within 48 h from admission. CONCLUSION:HTG-AP was found to be the 4th most common etiology of AP. HTG-APpatients had distinct baseline characteristics, but their clinical outcomes were similar compared to other etiologies of AP.
Authors: Pedram Paragomi; Alice Hinton; Ioannis Pothoulakis; Rupjyoti Talukdar; Rakesh Kochhar; Mahesh K Goenka; Aiste Gulla; Jose A Gonzalez; Vikesh K Singh; Miguel Ferreira Bogado; Tyler Stevens; Sorin T Barbu; Haq Nawaz; Silvia C Gutierrez; Narcis Zarnescu; Livia Archibugi; Jeffrey J Easler; Konstantinos Triantafyllou; Mario Peláez-Luna; Shyam Thakkar; Carlos Ocampo; Gregory A Cote; Peter J Lee; Somashekar Krishna; Luis F Lara; Samuel Han; Bechien U Wu; Georgios I Papachristou Journal: Clin Gastroenterol Hepatol Date: 2021-09-17 Impact factor: 13.576
Authors: Ioannis Pothoulakis; Haq Nawaz; Pedram Paragomi; Kwonho Jeong; Rupjyoti Talukdar; Rakesh Kochhar; Mahesh Kumar Goenka; Aiste Gulla; Vikesh K Singh; Jose A Gonzalez; Miguel Ferreira; Sorin T Barbu; Tyler Stevens; Silvia C Gutierrez; Narcis O Zarnescu; Gabriele Capurso; Jeffrey Easler; Konstantinos Triantafyllou; Mario Pelaez-Luna; Shyam Thakkar; Carlos Ocampo; Enrique de-Madaria; Bechien U Wu; Gregory A Cote; Kaleab Abebe; Gong Tang; Ali Lahooti; Anna E Phillips; Georgios I Papachristou Journal: United European Gastroenterol J Date: 2021-02-12 Impact factor: 4.623