Ioannis Pothoulakis1,2, Pedram Paragomi1, Marie Tuft1, Ali Lahooti3, Livia Archibugi4,5, Gabriele Capurso4,5, Georgios I Papachristou6,7. 1. University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 2. MedStar Washington Hospital Center, Washington, District of Columbia, USA. 3. Ohio State University Wexner Medical Center, Columbus, Ohio, USA. 4. Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan, Italy. 5. Digestive and Liver Disease Unit, Sant Andrea Hospital, Rome, Italy. 6. University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA, georgios.papachristou@osumc.edu. 7. Ohio State University Wexner Medical Center, Columbus, Ohio, USA, georgios.papachristou@osumc.edu.
Abstract
BACKGROUND: Hypertriglyceridemia (HTG) is considered within the top 5 etiologies in acute pancreatitis (AP), but the association of serum triglyceride (TG) levels with the clinical course of AP remains controversial. OBJECTIVES: This study aims to examine the effect of TG levels on severity of AP. METHODS: Patients were enrolled prospectively through APPRENTICE. High TG levels were defined based on the Endocrine Society Clinical Practice Guidelines. HTG was categorized as mild (serum TG levels 150-199 mg/dL), moderate (200-999 mg/dL), severe (1,000-1,999 mg/dL), and very severe (≥2,000 mg/dL). Severity of AP was based on the revised Atlanta classification criteria. RESULTS: Early TG levels were measured in 764 subjects and found elevated in 342 (120 with mild; 176, moderate; and 46, severe/very severe HTG). Patients with increased TG levels were younger (age ≥60, 16.7 vs. 30.3%), more likely to be male (66.1 vs. 51.2%), with more frequent alcohol use (62.8 vs. 50.7%), and diabetes mellitus (30.2 vs. 12.3%; all p ≤ 0.005). Severe AP (24.9 vs. 10.0%), ICU admission (32.5 vs. 19.7%), and mortality (5.3 vs. 1.7%; all p ≤ 0.005) were more frequently seen in patients with elevated TG levels. Based on multivariable analysis, elevated TG levels were independently associated with severe AP (p < 0.05). CONCLUSION: This large multicenter study confirms that elevated TG levels are associated with severe disease regardless of AP etiology.
BACKGROUND: Hypertriglyceridemia (HTG) is considered within the top 5 etiologies in acute pancreatitis (AP), but the association of serum triglyceride (TG) levels with the clinical course of AP remains controversial. OBJECTIVES: This study aims to examine the effect of TG levels on severity of AP. METHODS: Patients were enrolled prospectively through APPRENTICE. High TG levels were defined based on the Endocrine Society Clinical Practice Guidelines. HTG was categorized as mild (serum TG levels 150-199 mg/dL), moderate (200-999 mg/dL), severe (1,000-1,999 mg/dL), and very severe (≥2,000 mg/dL). Severity of AP was based on the revised Atlanta classification criteria. RESULTS: Early TG levels were measured in 764 subjects and found elevated in 342 (120 with mild; 176, moderate; and 46, severe/very severe HTG). Patients with increased TG levels were younger (age ≥60, 16.7 vs. 30.3%), more likely to be male (66.1 vs. 51.2%), with more frequent alcohol use (62.8 vs. 50.7%), and diabetes mellitus (30.2 vs. 12.3%; all p ≤ 0.005). Severe AP (24.9 vs. 10.0%), ICU admission (32.5 vs. 19.7%), and mortality (5.3 vs. 1.7%; all p ≤ 0.005) were more frequently seen in patients with elevated TG levels. Based on multivariable analysis, elevated TG levels were independently associated with severe AP (p < 0.05). CONCLUSION: This large multicenter study confirms that elevated TG levels are associated with severe disease regardless of AP etiology.
Authors: Ioannis Pothoulakis; Pedram Paragomi; Livia Archibugi; Marie Tuft; Rupjyoti Talukdar; Rakesh Kochhar; Mahesh Kumar Goenka; Aiste Gulla; Vikesh K Singh; Jose A Gonzalez; Miguel Ferreira; Sorin T Barbu; Tyler Stevens; Haq Nawaz; Silvia C Gutierrez; Narcis O Zarnescu; Jeffrey Easler; Konstantinos Triantafyllou; Mario Pelaez-Luna; Shyam Thakkar; Carlos Ocampo; Enrique de-Madaria; Bechien U Wu; Gregory A Cote; Gong Tang; Georgios I Papachristou; Gabriele Capurso Journal: Pancreatology Date: 2020-02-19 Impact factor: 3.996
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Authors: Georgios I Papachristou; Jorge D Machicado; Tyler Stevens; Mahesh Kumar Goenka; Miguel Ferreira; Silvia C Gutierrez; Vikesh K Singh; Ayesha Kamal; Jose A Gonzalez-Gonzalez; Mario Pelaez-Luna; Aiste Gulla; Narcis O Zarnescu; Konstantinos Triantafyllou; Sorin T Barbu; Jeffrey Easler; Carlos Ocampo; Gabriele Capurso; Livia Archibugi; Gregory A Cote; Louis Lambiase; Rakesh Kochhar; Tiffany Chua; Subhash Ch Tiwari; Haq Nawaz; Walter G Park; Enrique de-Madaria; Peter J Lee; Bechien U Wu; Phil J Greer; Mohannad Dugum; Efstratios Koutroumpakis; Venkata Akshintala; Amir Gougol Journal: Ann Gastroenterol Date: 2016-12-01