Shafiq Syed, Patil Mallikarjun, Gowda Vinod, Devarbhavi Harshad
Department of Medical Gastroenterology, St. John's Medical College and Hospital, Bengaluru, Karnataka, India.
Indian J Endocrinol Metab. 2022 Sep-Oct;26(5):459-464. doi: 10.4103/ijem.ijem_206_22. Epub 2022 Nov 22.
Although hypertriglyceridemia (HTG) is a well-established cause of acute pancreatitis (AP), there are no definitive management guidelines. Studies comparing clinical severity and outcome of hypertriglyceridemia-induced acute pancreatitis (HTGAP) and non- HTGAP are scarce. Hence, the present study was undertaken.
All consecutive patients admitted with AP from January 2017 to August 2021 at university teaching hospital were included in this study. Data with regards to patient demographics; clinical, laboratory, and radiologic parameters; management strategies; and outcome were collected and compared between HTGAP and non-HTGAP patients.
Overall, 550 patients with AP were admitted during the study period, of which 21 (3.8%) were HTG related. Mean age of HTGAP patients was 34.3 years (M: F = 14:7), and the mean serum triglyceride (TG) levels on admission were 3,718.9 mg/dL (range 1,094-11,991). Insulin infusion therapy was used in 18 patients with HTGAP and the target TG levels of ≤500 mg/dL was achieved in 4.2 days (mean). Compared to non-HTGAP patients, HTGAP patients had higher body mass index (29.2 vs. 25.6), higher clinical (BISAP 2.6 vs. 2.06) and radiologic severity scores (CT severity score 7.5 v/s 4.8), and required prolonged hospital stay (12.9 vs. 6.5 days).
HTGAP occurred in young patients with high BMI and was associated with more severe disease, that required prolonged hospitalization than patients with non-HTGAP. Insulin infusion therapy was effective in reducing serum TG levels.
尽管高甘油三酯血症（HTG）是急性胰腺炎（AP）的一个公认病因，但尚无明确的管理指南。比较高甘油三酯血症性急性胰腺炎（HTGAP）和非HTGAP的临床严重程度及结局的研究较少。因此，开展了本研究。
本研究纳入了2017年1月至2021年8月在大学教学医院连续收治的所有AP患者。收集了患者人口统计学资料、临床、实验室和放射学参数、管理策略及结局等数据，并在HTGAP和非HTGAP患者之间进行比较。
总体而言，研究期间共收治550例AP患者，其中21例（3.8%）与HTG相关。HTGAP患者的平均年龄为34.3岁（男∶女 = 14∶7），入院时平均血清甘油三酯（TG）水平为3718.9mg/dL（范围1094 - 11991）。18例HTGAP患者接受了胰岛素输注治疗，平均4.2天达到目标TG水平≤500mg/dL。与非HTGAP患者相比，HTGAP患者的体重指数更高（29.2对25.6），临床（BISAP评分2.6对2.06）和放射学严重程度评分更高（CT严重程度评分7.5对4.8），且住院时间更长（12.9天对6.5天）。
HTGAP发生于高BMI的年轻患者，与更严重的疾病相关，比非HTGAP患者需要更长的住院时间。胰岛素输注治疗在降低血清TG水平方面有效。
