Dynamic changes of lipid profile in severe hypertriglyceridemia-induced acute pancreatitis patients under double filtration plasmapheresis: a retrospective observational study

Abstract

Background To investigate the dynamic change of lipid profile under double filtration plasmapheresis (DFPP) in severe hypertriglyceridemia-induced acute pancreatitis (sHTGP) patients and ascertain the association between these changes and the clinical prognosis. Methods sHTGP patients admitted within 72 h after disease onset were included, and all the patients received DFPP within 24 h after admission. Lipid profile were detected on admission, consecutive 4 days after DFPP and at discharge. Results There were 47 sHTGP patients enrolled in this study. At admission, all the parameters of lipid profile changed significantly except for low density lipoprotein. In the first day after DFPP, the serum level of TG, cholesterol and very low density lipoprotein declined significantly, while the high-density lipoprotein (HDL) as well as apoprotein A1 elevated obviously (P < 0.05). TG maintained the downward trend in the following three days and the other parameters kept steady. Linear regression analysis showed that HDL was negatively correlated with the duration of hospitalization among three adjusted models (P = 0.043, P = 0.029, P = 0.025 respectively). Conclusion There was distinct fluctuation of the lipid profile upon the burst of sHTGP and the parameters changed significantly in the first day after DFPP. Among these parameters, HDL may serve as a biomarker for disease prognosis in patients with sHTGP.

Therapeutic Plasma Exchange in ICU Patients with Acute Hypertriglyceridemia-Induced Pancreatitis Improves Patient Outcomes

“…This may be related to a higher incidence of metabolic syndrome [29] and, in particular, alcohol-related HTG in the male gender [30,31]. Moreover, they demonstrated that triglycerides were effectively reduced by plasma exchange [14], as did several other studies [10,[32][33][34]. These findings are comparable to the results of our study.…”

“…In patients with severe hyperlipidemia refractory to diet and lipid-lowering drugs, apheresis is the therapy of choice. There is a large body of literature that demonstrates that apheresis is a very effective and safe treatment for lowering cholesterol levels [32,33,[39][40][41]. In this context, Chen et al [42] showed that plasmapheresis was more effective in terms of lowering triglycerides for patients with HTGP and high cholesterol levels (>12.4 mmol/L) compared to low cholesterol levels.…”

Efficacy and cost of double filtration plasmapheresis in severe hypertriglyceridemia‐induced pancreatitis: A retrospective observational study

“…To compensate for the slow effect of pharmacological therapies, DFPP was performed in sHTGP patients and has been proven effective for decades 6,10 . The efficacy of DFPP was tested in 47 sHTGP patients by Zheng et al, who discovered that the parameters were altered dramatically on the first day after DFPP 11 . This study revealed similar results, and the effect was maintained until discharge.…”

Initiation time of double-filtration plasma apheresis affects the risk of persistent organ failure in hypertriglyceridaemia-induced acute pancreatitis: a retrospective study

“…Double ltration plasmapheresis (DFPP) is a selective method of TPE [20] . Because DFPP has the advantage of reducing the need for fresh frozen plasma (FFP) as a replacement uid and signi cantly reducing the risk of allergic reactions and viral infections secondary to FFP, it has been increasingly used to treat HTG-AP in recent years [20][21][22][23][24][25][26][27] . However, there is little evidence to conclude that DFPP has an effect on improving outcomes of patients with HTG-AP, particularly in terms of reducing organ injury [22][23][24][25] .…”

“…However, there is little evidence to conclude that DFPP has an effect on improving outcomes of patients with HTG-AP, particularly in terms of reducing organ injury [22][23][24][25] . It has been reported that rapid TG clearance by DFPP in the clinical setting may not translate into a theoretical effect [26][27] . As mentioned in the relevant literature, the timing of apheresis treatment may be critical to its effect on the outcomes in the early stage of HTG-AP [4,15,28−29] .…”