Acute Pancreatitis Due to Hypertriglyceridaemia in Pregnancy

Gök, Funda; Köker, Selçuk; Kılıçaslan, Alper; Sarkılar, Gamze; Yosunkaya, Alper; Otelcioğlu, Şeref

doi:10.5152/tjar.2014.83435

Cited by 9 publications

(5 citation statements)

References 19 publications

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“…Inflammatory mediators damage alveoli and cause respiratory failure, which is the most common organ failure associated with SAP. 25 The occurrence of respiratory failure was also observed in the current study. In the group that had an admission TG of over 11.2 mmol/L, the incidence of respiratory failure was as high as 38.8% (Table 5), which was much higher than the cases with TG lower than 11.2 mmol/L (P<0.05).…”

Section: Discussionsupporting

confidence: 78%

“…Plasma exchange is also effective to reduce blood lipid levels urgently. 25,33 Several studies have confirmed that plasma exchange can quickly eliminate harmful cytokines and inflammatory mediators in the circulation to significantly improve clinical symptoms. 33,34 There is no large-scale study of plasma exchange in acute pancreatitis patients with hyperlipidemia.…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Admission Serum Triglyceride Level on the Prediction of Severity of Acute Pancreatitis in Pregnancy

Sheng¹,

Wang²,

Xu³

et al. 2021

RMHP

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Purpose: Previous studies indicated that the serum triglyceride level in patients with acute pancreatitis positively correlated with the severity of the disease among the general population. Despite the physiological hypertriglyceridemia in pregnant women, there are no reports on the relationship between serum triglyceride level and the severity of acute pancreatitis in pregnant (APIP) women. This study explores the relationship between serum triglyceride levels and the severity of APIP. Patients and Methods: Clinical information of APIP patients admitted to the Shengjing Affiliated Hospital of China Medical University was gathered from January 2012 to December 2020 to conduct retrospective research. The participating patients were divided into mild, moderately severe, and severe acute pancreatitis. The clinical outcomes of patients with different serum triglyceride levels (0-2.3 mmol/L, 2.23-5.65 mmol/L, 5.65-11.2 mmol/ l, ≥11.2 mmol/L) were analyzed by performing ordinal logistic regression analysis. Receiver operating curve analysis was used to calculate the threshold value of serum triglyceride concentration that can effectively predict the occurrence of severe acute pancreatitis (SAP). Results: Hypertriglyceridemic acute pancreatitis (HTG-AP) occurred in 47% of APIP patients within the group, with a high prevalence among the Han population. In the present study, the serum triglyceride concentration correlated positively with the severity of APIP (r=0.403, P < 0.05). The adjusted logistic model demonstrated that relative to nominal triglyceride levels, the OR value of SAP were 1.036 (95% CI: 0.401-2.677), ) with triglyceride at the level of 2.23-5.65 mmol/L, 5.65-11.2 mmol/l and ≥11.2 mmol/L. In APIP patients, a triglyceride concentration of 10.7mmol/L or more upon admission was a predictive value for the occurrence of SAP, with a sensitivity of 0.72 and a specificity of 0.65, AUC: 0.708 (95% CI: 0.620-0.796). Conclusion:As the serum triglyceride level upon admission increased, the frequency of local and systemic complications increased significantly.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

The Effect of Admission Serum Triglyceride Level on the Prediction of Severity of Acute Pancreatitis in Pregnancy

Sheng¹,

Wang²,

Xu³

et al. 2021

RMHP

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“…Simultaneously, TG was hydrolyzed by pancreatic lipase to excess free fatty acids (FFA), which seriously damaged acinar cells and pancreatic capillary endothelium, leading to severe self-digestion of the pancreas and activation of in ammatory cells. [29] Additional, TC can lead to in ammatory responses, lysosome damage, and pro-in ammatory cytokine secretion. [30] In particular, it promoted the toll-like receptors signal enhancement, the progress in AP played a signi cant proin ammatory role.…”

Section: Results In the Context Of What Is Knownmentioning

confidence: 99%

Acute Pancreatitis in Pregnancy: A Propensity Score Matching Analysis and Dynamic Nomogram for Risk Assessment

Tang,

Chen,

Huang

et al. 2024

Dig Dis Sci

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BACKGROUND: Acute pancreatitis is easily confused with abdominal pain symptoms, and it could lead to serious complications for pregnant women and fetus, the mortality was as high as 3.3% and 11.6%-18.7%, respectively. However, there is still lack of sensitive laboratory markers for early diagnosis of APIP and authoritative guidelines to guide treatment. ONJECTIVE:The purpose of this study was to explore the risk factors of acute pancreatitis in pregnancy, establish and evaluate the dynamic prediction model of risk factors in acute pancreatitis in pregnancy patients.STUDY DESIGN: Clinical data of APIP patients and non-pregnant acute pancreases patients who underwent regular antenatal check-ups during the same period were collected. The data set after propensity matching was randomly divided into training set and veri cation set at a ratio of 7:3. The model was constructed by using Logistic regression, least absolute shrinkage and selection operator regression, R language and other methods. The training set model was used to construct the diagnostic nomogram model and the validation set was used to validate the model. Finally, the accuracy and clinical practicability of the model were evaluated. RESULTS: A total of 111 APIP were included. In all APIP patients, biliary pancreatitis was the most important reason (62.1%). The levels of serum amylase, creatinine, albumin, triglyceride, high density lipoprotein cholesteroland apolipoprotein A1 were signi cantly different between the two groups. The propensity matching method was used to match pregnant pancreatitis patients and pregnant non-pancreatic patients 1:1 according to age and gestational age, and the matching tolerance was 0.02. The multivariate logistic regression analysis of training set showed that diabetes, triglyceride, Body Mass Index, white blood cell, C-reactive protein were identi ed and entered the dynamic nomogram. The area under the ROC curve of the training set was 0.942 and in validation set was 0.842. The calibration curve showed good predictive in training set, the calibration performance in the validation set was acceptable. The calibration curve showed the consistency between the nomogram model and the actual probability. CONCLUSION:The dynamic nomogram model we constructed to predict the risk factors of acute pancreatitis in pregnancy has high accuracy, discrimination and clinical practicability.

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“…[12] Afterwards, a great deal of FFAs in ltrate into the pancreatic cells and the acidic environment accelerates the activation of trypsinogen, which leads to severe self-digestion of pancreas and activation of in ammatory cells. [42] Owing to the cascade reaction of various in ammatory mediators, intensive systemic in ammatory response is marked in AP. And increased in ltration of in ammatory cells that observed in multiple organs according to other reports provide the additional evidence of our hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and early identification of acute pancreatitis in pregnancy with risk for organ failure: a retrospective study

Luo

et al. 2023

Preprint

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Background: Acute pancreatitis in pregnancy (APIP) with organ failure (OF) is a rare but serious disease. Here, we describe the primary characteristics associated with APIP, and explore potential predictors for early recognition of OF among the patients. Methods: A total of 3154 patients with AP from January 2018 to December 2021 were retrospectively reviewed. After screening, we enrolled 49 patients with APIP and 184 non-pregnant AP patients. Clinical characteristics and blood biochemical information were assessed using IBM SPSS 26.0 software and the rms package in R. Results: The most primary cause of APIP was hypertriglyceridemia (59.2%), while respiratory failure (46.9%) was the main type in all OF patients. Age, hemoglobin (Hb), hematocrit (HCT), aminotransferase (ALT), creatinine (Cr), blood urea nitrogen (BUN), albumin (ALB) and sodium ion (Na+) in the pregnant group were lower than in the non-pregnant group (P<0.05), while body mass index (BMI), triglyceride (TG) and total cholesterol (TC) in the pregnant group were higher (P<0.05). Among the APIP patients, BUN, TG and TC were independent risk factors for predicting OF, (P < 0.05) and they were used to create a nomogram with accurate prediction performance. (AUC=0.941) Conclusions: APIP was highly correlated with hypertriglyceridemia and respiratory failure. Higher BMI was a distinguishing feature of OF-APIP patients. The data indicate that close monitoring of BUN, TG and TC levels is essential for early prevention of OF in APIP patients.

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Acute Pancreatitis Due to Hypertriglyceridaemia in Pregnancy

Cited by 9 publications

References 19 publications

The Effect of Admission Serum Triglyceride Level on the Prediction of Severity of Acute Pancreatitis in Pregnancy

The Effect of Admission Serum Triglyceride Level on the Prediction of Severity of Acute Pancreatitis in Pregnancy

Acute Pancreatitis in Pregnancy: A Propensity Score Matching Analysis and Dynamic Nomogram for Risk Assessment

Clinical characteristics and early identification of acute pancreatitis in pregnancy with risk for organ failure: a retrospective study

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