Hyperlipidaemia, alcohol abuse and acute pancreatitis

Abstract

Of 311 patients with primary acute pancreatitis, seven revealed major and seven minor lipid abnormalities on hospital admission. One pregnant woman suffered acute pancreatitis associated with Fredrickson type I hyperlipoproteinaemia. Twelve of the 13 men with types IV and V hyperlipoproteinaemia suffered alcohol abuse pancreatitis and represented 13.2 per cent of this aetiological group. However, only one of the 157 patients (0.6 per cent) with biliary disease had lipid abnormalities. Two of the 13 men died--the oldest, who had gallstones, and one with alcohol related disease. The remaining 11 were subject to follow-up (5-10 years). Six, who had improvement of their lipid abnormalities, had abstained from alcohol. The other five had a persistent lipid disorder, and all admitted continuing heavy alcohol ingestion. The clinical diagnosis of acute pancreatitis was supported by serum amylase elevation in only nine of the fourteen patients. Urinary amylase levels were consistent with the diagnosis in 11 of the 12 patients. Estimation of both serum and urinary amylase gave 100 per cent support to the clinical diagnosis of acute pancreatitis. Hyperlipidaemia associated with acute pancreatitis may be secondary to alcohol abuse but the possible role of HLP cannot be discounted. Urinary amylase is useful in diagnosing acute pancreatitis in the presence of hyperlipidaemia.

Chronic Alcohol Intake Increases the Severity of Pancreatitis Induced by Acute Alcohol Administration, Hyperlipidemia and Pancreatic Duct Obstruction in Rats

“…In the present study, acute intravenous alcohol administration was combined with 2 factors, hyperlipidemia and temporary obstruction of the pancreatic duct, for 2 h. The hyperlipidemia induced in the present study represents a moderate increase of triglycerides, as can be observed in many patients including those with chronic alcohol abuse [38]. However, the lipid levels achieved in the present study are not capable of inducing evident pancreatitis on their own.…”

Dyslipidaemic Pancreatitis Clinical Assessment and Analysis of Disease Severity and Outcomes

“…One quarter of this series had severe abnormalities, which translates to an 8% incidence in the cohort as a whole. Only one other study gave a prevalence of severe dyslipidaemias, which was 2% [4] . Obesity has been shown to be an independent risk factor for severe pancreatitis [ …”

“…Since first documented by Speck in 1846 [1] , the aetiopathogenic relationships of abnormalities of lipid metabolism to pancreatitis remain unclear [2][3][4] . Primary lipid disorders, especially those with triglycerides above 11.3 m M , cause episodes of acute pancreatitis [5] .…”

“…The prevalence of lipid abnormality in pancreatitis varies from 3.8 to 39%, depending on whether levels are routinely or selectively measured [3,4,13,14] . It is unclear whether dyslipidaemia alters the outcomes of pancreatitis.…”

Severe Acute Pancreatitis: Newer Insights in Diagnosis and Management

“…Various coagu lation disorders have been observed in AP [67][68][69][70] and could play a role in the pulmo nary and renal complications. Many other metabolic disturbances have been described: hyperglycemia [71], hyperlipemia [72,73], metabolic acidosis due to tissue hypoperfu sion during circulatory shock or renal fail ure. Hypocalcemia is a sign of severity in AP [8,12], Part of hypocalcemia is a conse quence of albumin loss, but a real fall in serum ionized calcium was shown.…”