JoVE - Journal of Visualized Experiments
JoVE Visualize
Contact Us

Early triglyceride-lowering therapy in acute pancreatitis with extremely high triglyceride levels

  • 0Department of Critical Care Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China (Drs Wang, Cao, Liu, Tong, Li, and Ke); Research Institute of Critical Care Medicine and Emergency Rescue, Nanjing University, Nanjing, China (Drs Wang, Li, and Ke).
Journal of Clinical Lipidology +

|

October 1, 2025

|

October 1, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Achieving target triglyceride levels quickly in hypertriglyceridemia-associated acute pancreatitis (HTG-AP) significantly reduces severe acute pancreatitis (SAP) risk. Plasmapheresis showed no advantage over medical treatment for SAP or triglyceride reduction.

Area Of Science

  • Gastroenterology
  • Endocrinology
  • Critical Care Medicine

Background

  • Initial triglyceride levels significantly impact triglyceride-lowering therapy effectiveness in hypertriglyceridemia-associated acute pancreatitis (HTG-AP).
  • Understanding the relationship between triglyceride decline and disease severity is crucial for managing HTG-AP.

Purpose Of The Study

  • To assess if timely triglyceride reduction and various triglyceride-lowering therapies correlate with disease severity in HTG-AP patients presenting with extremely high triglycerides.
  • To compare the efficacy of plasmapheresis versus medical management in reducing severe acute pancreatitis (SAP) risk.

Main Methods

  • A registry-based cohort study including 90 patients with on-admission triglyceride levels ≥45.2 mmol/L.
  • Patients were categorized by day 3 triglyceride levels (target <5.65 mmol/L vs. non-target ≥5.65 mmol/L) and treatment modality (plasmapheresis vs. medical).
  • Multivariable logistic regression and generalized estimating equation models analyzed the association with severe acute pancreatitis (SAP).

Main Results

  • Among 80 patients with day 3 triglycerides, 33.8% reached the target level.
  • Achieving the triglyceride target was significantly associated with a decreased risk of SAP (OR, 0.12; P = .009).
  • Plasmapheresis did not demonstrate a significant association with reduced SAP risk (OR, 1.98; P = .291) or faster triglyceride decline compared to medical treatment.

Conclusions

  • Timely triglyceride decline is a key factor in reducing the risk of severe acute pancreatitis (SAP) in HTG-AP patients with very high triglyceride levels.
  • Plasmapheresis does not appear to offer advantages over medical therapy regarding SAP development or the speed of triglyceride reduction in this patient group.

Keywords:

Related Concept Videos

Acute Pancreatitis II: Clinical Manifestations and Management 01:30

756

Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...

Acute Pancreatitis I: Introduction 01:27

1.1K

Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:

...

Chronic Pancreatitis II: Collaborative Care 01:29

313

The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:

Detailed History: Understanding the patient's symptoms is critical. It includes inquiring about abdominal pain, weight loss, and digestive issues, which are common in chronic pancreatitis.
Physical Examination: This might reveal abdominal tenderness, jaundice, and signs of malnutrition,...

Chronic Pancreatitis I: Introduction 01:24

667

The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...

Lipid-Lowering Drugs: Statins and Miscellaneous Agents 01:20

1.3K

Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...

Glucagon-like Receptor Agonists 01:24

848

Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...