High triglyceride levels exacerbate severity, complications of acute pancreatitis in NAFLD
Click Here to Manage Email Alerts
Key takeaways:
- Hypertriglyceridemia was associated with a higher incidence of moderately severe and severe acute pancreatitis in NAFLD.
- Related complications included organ failure and acute peripancreatic fluid collection.
Elevated serum triglyceride levels were associated with severity of acute pancreatitis and risk for related complications, including organ failure, among patients with nonalcoholic fatty liver disease, according to data.
“Studies have shown that abnormal lipid metabolism has an important impact on the severity and prognosis of acute pancreatitis (AP),” researchers at Northern Jiangsu People’s Hospital wrote in BMC Gastroenterology. “A retrospective study found that NAFLD can exacerbate the severity of AP, which is worsened with the increased severity of NAFLD. As [serum triglyceride] is a common risk factor for both, there are few studies on the correlation between the three.”
In a retrospective study, researchers assessed the relationship between serum triglycerides and severity of acute pancreatitis among 598 adults (mean age, 46.1 years; 64.7% men) with NAFLD who were hospitalized from 2016 to 2020. Nearly half of the patients had moderately severe acute pancreatitis (49.2%), followed by mild (45.7%) and severe (5.2%) disease, according to the 2012 revision of Atlanta classification.
Researchers further grouped patients by serum triglyceride levels, identifying 433 with hypertriglyceridemia and 165 with non-hypertriglyceridemia. Hyperlipidemia was defined as serum triglyceride levels of at least 1.7 mmol/L, which ranged from mild (1.7-2.3 mmol/L), moderate (2.3-11.2 mmol/L), severe (11.2-22.4 mmol/L) and very severe (≥ 22.4 mmol/L).
Researchers noted that patients in the hypertriglyceridemia group had significantly higher BMI (26.8 vs. 25.4) and waist circumference (90.8 vs. 86.7) compared with those in the non-hypertriglyceridemia group.
Further, incidence of moderately severe (50.3% vs. 46.1%) and severe acute pancreatitis (6.5% vs. 1.8%) was significantly higher in the hypertriglyceridemia group. This group also had a higher incidence of persistent organ failure (6.5% vs. 1.8%), especially persistent respiratory failure (5.3% vs. 1.2%), and were more likely to experience local complications, including acute peripancreatic fluid collection (52.2% vs. 42.2%).
When serum triglyceride levels were 5.65 mmol/L or higher, the proportion of patients with moderate to severe NAFLD also was higher (57.4% vs. 38.9%), which demonstrated that “NAFLD is relatively more severe when [serum triglyceride] is high,” researchers wrote.
According to multivariate logistic regression analysis, independent risk factors for acute peripancreatic fluid collection included BMI (OR = 0.947; 95% CI, 0.906-0.99), serum triglyceride (OR = 1.017; 95% CI, 1.007-1.028) and acute pancreatitis recurrence (≥ 2 times; OR = 1.702; 95% CI, 1.03-2.813), as well as moderate (OR = 2.353; 95% CI, 1.28-4.323) and severe (OR = 3.252; 95% CI, 1.623-6.516) NAFLD.
Further, the risk for acute peripancreatic fluid collection was 2.353 and 3.252 times higher among patients with moderate and severe NAFLD, respectively, compared with those with mild NAFLD.
“[Serum triglyceride] is closely related to the severity and local complications in patients with [acute pancreatitis] complicated with NAFLD and is an independent risk factor for the development of local complications,” researchers concluded.
Collapse
Read more about
Click Here to Manage Email Alerts