Hypertriglyceridaemia-Induced Acute Pancreatitis: A Different Disease Phenotype

Area of Science:

• Gastroenterology and Hepatology
• Internal Medicine
• Biomarker Discovery

Background:

• Acute pancreatitis (AP) is a leading cause of hospitalization.
• Severe hypertriglyceridaemia (HTG) is a significant, yet less common, etiology of AP (HTGAP).
• HTGAP is suspected to have higher complication and severity rates compared to non-HTGAP.

Purpose of the Study:

• To compare complication rates between HTGAP and non-HTGAP.
• To identify predictive biomarkers for severe AP in HTGAP patients.

Main Methods:

• Retrospective study of 262 AP patients.
• Patients categorized into HTGAP (11%) and non-HTGAP groups.
• Analysis of demographic data, comorbidities (diabetes mellitus), disease severity, complications, biomarkers (CRP, hematocrit, BUN), hospital stay, and mortality.

Main Results:

• HTGAP patients were younger (44.4 vs. 58.2 years) and had higher rates of diabetes mellitus (53% vs. 18%).
• HTGAP showed a more severe inflammatory response (higher CRP at 48h) and a trend towards more local complications.
• Hematocrit (HT) and blood urea nitrogen (BUN) at 48 hours demonstrated high predictive value (AUC > 0.8) for severe AP; BUN at 48h was an independent predictor.

Conclusions:

• HTGAP is associated with a more severe inflammatory profile and potentially higher rates of local complications compared to non-HTGAP.
• BUN and hematocrit levels at 48 hours post-admission are valuable predictive markers for severe AP in the context of HTG.
• Further research is warranted to elucidate the specific mechanisms driving HTGAP severity and to optimize management strategies.