Long-term Follow-up of Patients With Acute Hypertriglyceridemia-Induced Pancreatitis

Athyros, Vasilios G.; Γιουλεμέ, Όλγα; Nikolaidis, Nikolaos; Vasiliadis, Themistoklis V.; Bouloukos, Vassilios I.; Kontopoulos, Athanasios G.; Eugenidis, Nikolaos

doi:10.1097/00004836-200204000-00020

Cited by 161 publications

(101 citation statements)

References 24 publications

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“…HTG-associated SAP is an uncommon, but potentially life-threatening disease [14] . HTG may be primary in origin (hereditary or sporadic genetic disorder of metabolism) or secondary (associated with an identifiable disease or condition and is reversible with control or eradication of that disease or condition) to other factors or both [15][16][17] .…”

Section: Discussionmentioning

confidence: 99%

Effect of admission hypertriglyceridemia on the episodes of severe acute pancreatitis

Deng¹,

Xue²,

Xia³

et al. 2008

WJG

159

108

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A I M : To i n v e s t i g a t e t h e e f f e c t o f a d m i s s i o n hypertriglyceridemia (HTG) on the episodes of severe acute pancreatitis (SAP). METHODS:One hundred and seventy-six patients with SAP were divided into HTG group (n = 45) and control group (n = 131) according to admission triglyceride (TG) ≥ 5.65 mmol/L and < 5.65 mmol/L, respectively. Demographics, etiology, underlying diseases, biochemical parameters, Ranson' s score, acute physiology and chronic heath evaluation Ⅱ (APACHE Ⅱ) score, Balthazar's computed tomography ( C T ) s c o r e , c o m p l i c a t i o n s a n d m o r t a l i ty w e r e compared. Correlation between admission TG and 24-h APACHE Ⅱ score was analyzed. RESULTS: SAP patients with HTG were younger (40.8 ± 9.3 years vs 52.6 ± 13.4 years, P < 0.05) with higher etiology rate of overeating, high-fat diet (40.0% vs 14.5%, P < 0.05) and alcohol abuse (46.7% vs 23.7%, P < 0.01), incidence rate of hypocalcemia (86.7% vs 63.4%, P < 0.01) and hypoalbuminemia (84.4% vs 60.3%, P < 0.01), 24-h APACHE Ⅱ score (13.6 ± 5.7 vs 10.7 ± 4.6, P < 0.01) and admission serum glucose (17.7 ± 7.7 vs 13.4 ± 6.1, P < 0.01), complication rate of renal failure (51.1% vs 16.8%, P < 0.01), shock (37.9% vs 14.5%, P < 0.01) and infection (37.4% vs 18.3%, P < 0.01) and mortality (13.1% vs 9.1%, P < 0.01). Logistic regression analysis showed a positive correlation between admission TG and 24-h APACHE Ⅱ score (r = 0 .509, P = 0.004).

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Section: Discussionmentioning

confidence: 99%

Effect of admission hypertriglyceridemia on the episodes of severe acute pancreatitis

Deng¹,

Xue²,

Xia³

et al. 2008

WJG

159

108

View full text Add to dashboard Cite

show abstract

“…It is generally accepted that levels greater than 1000 mg/dL are required to precipitate an episode of pancreatitis, but such levels of TG do not always cause HTGP. 38 The most recent ATP III guidelines suggest that a normal TG level is considered to be less than 150 mg/dl, while those greater than 500 mg/dl are considered very high 39 . Pancreatic lipase, a digestive enzyme concentrated in the exocrine pancreas which participates in TG degradation, may be liberated in AP and act in an unregulated fashion to contribute to tissue breakdown 40 .…”

Section: Pathophysiology Of Hypertriglyceridemic Pancreatitismentioning

confidence: 99%

Hypertriglyceride Induced Acute Pancreatitis

Lebenson¹,

Oliver²

2012

Acute Pancreatitis

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“…The triglyceride level should be reduced to Ͻ500 mg/dL to prevent this serious disease [SOR-B]. 1,4,5 The relationship between triglycerides and cardiovascular disease is less clear. There have been multiple conflicting studies regarding the role of triglycerides and the development of CHD.…”

Section: Treatmentmentioning

confidence: 99%

“…Although a few patients can develop pancreatitis with triglyceride levels Ͼ500 mg/dL, the risk for pancreatitis does not become clinically significant until levels are Ͼ1000 mg/dL. 1,4,5 More importantly however, hypertriglyceridemia is typically not an isolated abnormality. It is frequently associated with other lipid abnormalities and the metabolic syndrome (abdominal obesity, insulin resistance, low high-density lipoprotein (HDL), high triglyceride, and hypertension), which are linked to coronary artery disease.…”

mentioning

confidence: 99%

Hypertriglyceridemia

Pejic¹,

Lee²

2006

The Journal of the American Board of Family Medicine

105

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Hypertriglyceridemia is a commonly encountered lipid abnormality frequently associated with other lipid and metabolic derangements. The National Cholesterol Education Program recommends obtaining a fasting lipid panel in adults over the age of 20. The discovery of hypertriglyceridemia should prompt an investigation for secondary causes such as high fat diet, excessive alcohol intake, certain medications, and medical conditions (eg, diabetes mellitus, hypothyroidism). In addition, patients should be evaluated for other components of the metabolic syndrome. These include abdominal obesity, insulin resistance, low high-density lipoprotein (HDL), high triglyceride, and hypertension. Hypertriglyceridemia is classified as primary hypertriglyceridemia when there are no secondary causes identified. Primary hypertriglyceridemia is the result of various genetic defects leading to disordered triglyceride metabolism. It is important to treat hypertriglyceridemia to prevent pancreatitis by reducing triglyceride levels to <500 mg/dL. Furthermore, lowering triglycerides while treating other dyslipidemias and components of the metabolic syndrome will reduce coronary events. However, it is controversial how much isolated hypertriglyceridemia correlates directly with coronary artery disease and further studies are needed to clarify whether treatment for this condition leads to meaningful clinical outcomes. Therapeutic lifestyle changes (TLC) are the first line of treatment for hypertriglyceridemia. These changes include a low saturated fat, carbohydrate-controlled diet, combined with alcohol reduction, smoking cessation, and regular aerobic exercise. High doses of omega-3 fatty acids from fish and fish oil supplements will lower triglyceride levels significantly. When patients do not reach their goals by TLC, drug therapy should be started. In cases of isolated hypertriglyceridemia, fibrates are initially considered. When elevated low-density lipoprotein levels accompany hypertriglyceridemia, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors are preferred. In patients with low HDL levels and hypertriglyceridemia, extended release niacin can be considered.

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Long-term Follow-up of Patients With Acute Hypertriglyceridemia-Induced Pancreatitis

Abstract: Appropriate diet and drug treatment, including dose titration, of severe HTG is very effective in preventing relapses of HTG-induced AP.

Cited by 161 publications

References 24 publications

Effect of admission hypertriglyceridemia on the episodes of severe acute pancreatitis

Effect of admission hypertriglyceridemia on the episodes of severe acute pancreatitis

Hypertriglyceride Induced Acute Pancreatitis

Hypertriglyceridemia

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