Significantly different clinical features between hypertriglyceridemia and biliary acute pancreatitis: a retrospective study of 730 patients from a tertiary center

Abstract

BackgroundUnlike western world, gallstones and hypertriglyceridemia (HTG) are among the first two etiologies of acute pancreatitis (AP) in China. But yet, detailed differences in clinical features and outcomes between hypertriglyceridemia and biliary acute pancreatitis have not been well described.MethodsThis retrospective study enrolled 730 acute pancreatitis patients from July 1, 2013 to October 1, 2016 in Jinling Hospital. The causes of the study patients were defined according to specific diagnostic criteria. The clinical features and outcomes of patients with hypertriglyceridemia acute pancreatitis (HTG-AP) and biliary acute pancreatitis (BAP) were compared in terms of general information, disease severity, laboratory data, system complications, local complications, and clinical outcome.ResultsIn the enrolled 730 AP patients, 305 (41.8%) were HTG-AP, and 425 (58.2%) were BAP. Compared to BAP, the HTG-AP patients were found to be younger, with higher body mass Index (BMI), and much higher proportion of diabetes, fatty liver and high fat diet. Besides that, HTG-AP patients had significantly higher C-reactive protein (CRP) (p<0.01) and creatinine (p = 0.031), together with more acute respiratory distress syndrome (ARDS) (p = 0.039), acute kidney injury (AKI) (p<0.001), deep venous thrombosis (p = 0.008) and multiple organ dysfunction syndrome (MODS) (p = 0.032) in systematic complications. As for local complications, HTG-AP patients had significantly less infected pancreatitis necrosis (p = 0.005). However, there was no difference in mortality, hospital duration and costs between the groups.ConclusionHTG-AP patients were younger, more male, having high fat diet and with higher BMI compared to BAP patients. The prevalence of AKI/ARDS/DVT/MODS in HTG-AP patients was higher than BAP patients, while BAP patients had a greater possibility in development of infected pancreatitis necrosis (IPN). According to the multivariate analysis, only the complication of AKI was independently related with the etiology of HTG, however, BMI contributes to AKI, ARDS and DVT.Electronic supplementary materialThe online version of this article (10.1186/s12876-018-0821-z) contains supplementary material, which is available to authorized users.

Comparison of bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity of hyperlipidemic acute pancreatitis(HLAP)

“…Our study highlighted that there were more man(67.7% in MAP, 70.6% in MSAP and SAP) than woman(32.3% in MAP, 29.4% in MSAP and SAP) patients with young ages(39.8±11.0 in MAP, 39.7±11.0 in MSAP and SAP ) of HLAP, which was in line with the report of Li et al [10] . This phenomenon probably was responsible for strong work and life pressure, alcohol abuse, smoking, absent exercise, high-calorie food(such as high-fat diet, high-sugar diet), and irregular sleeping schedule in this group.…”

Identification of a novel LPL nonsense variant and further insights into the complex etiology and expression of hypertriglyceridemia-induced acute pancreatitis

“…Gallstones, alcohol abuse and massive hypertriglyceridemia (HTG) are generally thought to be three leading etiologies of AP worldwide [3]. However, unlike in Western countries, HTG, rather than alcohol abuse, is the second leading cause of AP in China [4]. Hypertriglyceridemiainduced acute pancreatitis (HTG-AP) is defined by serum triglyceride (TG) level exceeding 11.3 mmol/L (1000 mg/ dL) or between 5.6 to 11.3 mmol/L (500~1000 mg/dL) together with lipemic serum [5,6].…”

Comparative study of the outcome between alcohol and gallstone pancreatitis in a high‐volume tertiary care center

“…Still further, few studies highlighted that the outcome of HTG‐related AP has a more severe outcome. Li et al found higher rates of OF and complications in the HTG group compared to the biliary AP group, although no difference in the mortality was observed. While Zhu et al reported higher mortality in the HTG and alcohol groups compared to the biliary group, Zheng et al showed lower mortality rates in the HTG and biliary groups.…”