Multiple Hits in Acute Pancreatitis: Components of Metabolic Syndrome Synergize Each Other’s Deteriorating Effects

Szentesi, Andrea; Párniczky, Andrea; Vincze, Áron; Bajor, Judit; Gódi, Szilárd; Patrícia, Silvia; Gede, Noémi; Izbéki, Ferenc; Halász, Adrienn; Korbonits, M; Dobszai, Dalma; Török, Imola; Farkas, Hunor; Papp, Mária; Varga, Márta; Hamvas, József; Novák, Jan; Mickevičius, Artautas; Maldonado, Elena Ramirez; Sallinen, Ville; Illés, Dóra; Kui, Balázs; Erőss, Bálint; Czakó, László; Takács, Tamás

doi:10.3389/fphys.2019.01202

Cited by 57 publications

(50 citation statements)

References 41 publications

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“…In our study, though, the complications of AP were significantly higher in the MetS group than in the non-MetS group, but unlike the study mentioned, hypertension was not associated with an increase in AP severity based on the RAC and BISAP score. 17 In our study, increasing waist circumference, as an important indicator of obesity, was statistically significant associated with AP severity based on both criteria of the RAC and BISAP score (Tables 4-6). This result is consistent with the results of most studies suggesting that obesity has a negative impact on the AP process.…”

Section: Discussionsupporting

confidence: 52%

<p>Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis</p>

Niknam¹,

Moradi²,

Jahanshahi³

et al. 2020

DMSO

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Background: Acute pancreatitis (AP) and metabolic syndrome (MetS) are common clinical problems with serious complications and high cost of treatment. The relationship between MetS and severity of AP is unknown, and because there are very few published articles, further studies had been recommended. Therefore, we designed this study to estimate the association between MetS and its components with AP severity. Patients and Methods: In this prospective analytical cross-sectional study, all AP patients who referred to two referral hospitals affiliated with Shiraz University of Medical Sciences between 2016 and 2019 were evaluated. The diagnosis of MetS syndrome as well as follow-up of patients for evaluation of severity and outcome of AP was performed in all enrolled patients. National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III) was used for diagnosis of MetS. Bedside Index for Severity in Acute Pancreatitis (BISAP) and revised Atlanta classification (RAC) were used to estimate the severity of AP. Finally, the association between MetS syndrome and its components at different AP severities was compared. Results: Of the 214 patients referred to our center, a total of 76 patients with AP were included in this study. Of the included patients, 40 (52.6%) were male and 36 (47.4%) were female. Frequency of patients in Mets and non-MetS groups was 34 (44.74%) and 42 (55.26%), respectively. The gender and mean age difference between Mets and non-MetS groups were not statistically significant. According to Mets groups, 25 (73.5%) and 9 (26.5%) AP patients with MetS had BISAP score of 0-2 and 3-5, respectively. BISAP score in MetS group was significantly higher than non-MetS group (P = 0.022). Overall, 20 (58.8%), 11 (32.4%), and 3 (8.8%) of AP patients with MetS had mild, moderately severe, and severe AP based on RAC, respectively. Severe RAC was significantly higher in the MetS group than in the non-MetS group (P = 0.029). The frequency of complications in MetS group was significantly higher than in non-MetS group (P= 0.008). The length of hospital stay was also significantly higher in the MetS group than in the non-MetS group (P = 0.001). Overall, three patients died, two of whom had MetS and all had severe RAC and BISAP 3-5. Waist circumference, fasting blood sugar, and triglyceride were significantly higher in the severe and moderately severe types of AP group than in the mild AP group, according to RAC. Although, mean of all components of MetS except HDL-cholesterol were higher in BISAP of 3-5 group than BISAP of 0-2 group, the difference was only significant in waist circumference. Conclusion: The present study showed that there was a significant association between the rate of MetS and its components including waist circumference, hyperglycemia and hypertriglyceridemia with increasing AP severity. This study showed that the incidence of more severe AP in patients with MetS is much higher than in patients without MetS. We recommend that the new studies with larger sample sizes are conducted wit...

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Section: Discussionsupporting

confidence: 52%

<p>Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis</p>

Niknam¹,

Moradi²,

Jahanshahi³

et al. 2020

DMSO

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“…Zeng et al [93] verified that hypertriglyceridemia was associated with local and systemic complications. Szentesi et al [84] verified that hypertriglyceridemia elevated the risk of severe AP.…”

Section: Hyperlipidemiamentioning

confidence: 98%

“…Few studies related metabolic syndrome with acute pancreatitis and their results are varied. However, a high prevalence of metabolic syndrome has been found in patients with AP and some studies associate this syndrome to severe forms of AP [82][83][84]. Mikolasevic et al [82] showed that patients with metabolic syndrome had a significantly higher incidence of moderately severe and severe AP in comparison to those without metabolic syndrome.…”

Section: Metabolic Syndromementioning

confidence: 99%

Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

Silva-Vaz

Abrantes

Castelo‐Branco

et al. 2020

IJMS

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Acute pancreatitis (AP) is a severe inflammation of the pancreas presented with sudden onset and severe abdominal pain with a high morbidity and mortality rate, if accompanied by severe local and systemic complications. Numerous studies have been published about the pathogenesis of AP; however, the precise mechanism behind this pathology remains unclear. Extensive research conducted over the last decades has demonstrated that the first 24 h after symptom onset are critical for the identification of patients who are at risk of developing complications or death. The identification of these subgroups of patients is crucial in order to start an aggressive approach to prevent mortality. In this sense and to avoid unnecessary overtreatment, thereby reducing the financial implications, the proper identification of mild disease is also important and necessary. A large number of multifactorial scoring systems and biochemical markers are described to predict the severity. Despite recent progress in understanding the pathophysiology of AP, more research is needed to enable a faster and more accurate prediction of severe AP. This review provides an overview of the available multifactorial scoring systems and biochemical markers for predicting severe AP with a special focus on their advantages and limitations.

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“…According to the 2012 Atlanta classi cation, 24% patients met the diagnostic criteria of severe acute pancreatitis (SAP). 48.9% patients had recurrent AP (recurrence times: 2 [1,3]) and 36.1% patients were complicated with diabetes.…”

Section: Baseline and Clinical Characteristics Of Patients With Shtgpmentioning

confidence: 99%

“…Acute pancreatitis (AP) is an in ammatory disease of the pancreas with a worldwide incidence of cases per 100,000 per annum [1,2]. Metabolic syndrome was proved to be closely related to the development and/or severity of AP [3,4]. As one of the components of metabolic syndrome, severe hypertriglyceridemia (sHTG), de ned as a serum triglyceride (TG) level>11.3 mmol/L, is a common cause of AP [5,6].…”

Section: Introductionmentioning

confidence: 99%

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

Zheng

Wang

et al. 2020

Preprint

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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 72h after disease onset were included, and all the patients received DFPP within 24h 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.

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Multiple Hits in Acute Pancreatitis: Components of Metabolic Syndrome Synergize Each Other’s Deteriorating Effects

Cited by 57 publications

References 41 publications

<p>Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis</p>

<p>Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis</p>

Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

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

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