DOI: http://dx.doi.org/10.18203/2349-2902.isj20191274

Serum triglyceride level: a predictor of complications and outcomes in acute pancreatitis?

B. N. Anandaravi, L. Kalavathi

Abstract


Background: The aims and objectives were to analyse the influence of elevated triglyceride level in acute pancreatitis so the ability to predict the severity of acute pancreatitis can help identify the patients at increased risk of morbidity and mortality, therefore to make an early decision to triage these patients and treat accordingly.

Methods: An observational study was undertaken over a span of 6 months from January 2018 to June 2018 in K.R Hospital, Mysore, Karnataka, India. 50 Patients admitted with the diagnosis of acute pancreatitis, who had serum triglyceride levels measured within the first 24 hrs of admission, were divided into 2 groups. The study group consisted of patients with a triglyceride level ≥200 mg/dl (group 2) and the control group consisted of triglyceride level of ≤ 200 mg/dl (group 1). We collected the detailed history, data of laboratory values, incidence of complications like pleural effusion, acute kidney injury, pancreatic necrosis, shock, admission to ICU, length of total hospital stay and death.

Results: A total of fifty patients were included in the study out of which 42 patients had triglycerides of less than 200 mg/dl and 8 patients had triglycerides of more than 200 mg/dl. There was no significant difference in the incidence of pleural effusion and shock but there was significant difference in the incidence of acute kidney injury, pancreatic necrosis and Intensive care unit stay between the two groups.

Conclusions: A triglyceride level of more than 200 mg/dl on admission in acute pancreatitisis is an independent predictor of developing local and systemic complications, hospital stay, admission to ICU and death.

 


Keywords


Acute pancreatitis, Triglycerides, Complications

Full Text:

PDF

References


Lankisch PG, Apte M, Banks P. A. Acute pancreatitis. The Lancet. 2015;386(9988):85–96.

Peery AF, Dellon ES, Lund J, Crockett SD, McGowan CE, Bulsiewicz WJ, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143(5):1179–87.e3.

Hegele RA. Monogenic dyslipidemias: window on determinants of plasma lipoprotein metabolism Am J Hum Genet. 2001;69:1161.

Hodis HN, Mack WJ, Krauss RM, Alaupovic P. Pathophysiology of triglyceride‐rich lipoproteins in atherothrombosis: Clinical aspects. Clinical cardiology. 1999 Jun;22(S2):II-15.

Zechner R, Kienesberger PC, Haemmerle G, Zimmermann R, Lass A. Adipose triglyceride lipase and the lipolytic catabolism of cellular fat stores. J Lipid Res. 2009;50:3–21.

Lam PP, Cosen BL, Lugea A, Pandol SJ, Gaisano HY. Alcohol redirects CCK mediated apical exocytosis to the acinar basolateral membrane in alcoholic pancreatitis. Traffic. 2007;8:605–17.

Wang Y, Sternfeld L, Yang F, Rodriguez JA, Ross C, Hayden MR, et al. Enhanced susceptibility to pancreatitis in severe hypertriglyceridaemic lipoprotein lipase-deficient mice and agonist like function of pancreatic lipase in pancreatic cells. Gut. 2009;58:422–30.

Oh RC, Lanier JB. Management of hypertriglyceridemia. Am Family Physician. 2007;75(9):1365-71.

Balachandra S, Virlos IT, King NK, Siriwardana HP, France MW, Siriwardena AK. Hyperlipidaemia and outcome in acute pancreatitis. Int J Clin Pract. 2006;60(2):156-9.

Zeng Y, Zhang W, Lu Y, Huang C, Wang X. Impact of hypertriglyceridemia on the outcome of acute biliary pancreatitis. Am J Med Sci. 2014;348(5):399–402.

Pedersen SB, Langsted A, Nordestgaard BG. Nonfasting mild-to-moderate Hypertriglyceridemia and risk of acute pancreatitis. JAMA Intern Med. 2016;176:1834–42.

Tariq H, Gaduputi V, Peralta R, Abbas N, Nayudu SK, Thet P, et al. Serum Triglyceride Level: A Predictor of Complications and Outcomes in Acute Pancreatitis? Can J Gastroenterol Hepatol. 2016;2016:8198047.

Toskes PP. Hyperlipidemic pancreatitis. Gastroenterol Clin N Am. 1990;19(4):783–91.

Hasin DS, Stinson FS, Ogburn E, Grant BF. Prevalence, correlates, disability, and comorbidity of DSMIV alcohol abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch General Psychiatr. 2007;64(7):830–42.

Wu C, Ke L, Tong Z, Li B, Zou L, Li W, et al. Hypertriglyceridemia is a risk factor for acute kidney injury in the early phase of acute pancreatitis. Pancreas. 2014;43(8):1312-6.