Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 7, 2022; 28(29): 3946-3959
Published online Aug 7, 2022. doi: 10.3748/wjg.v28.i29.3946
Incidence and clinical characteristics of hypertriglyceridemic acute pancreatitis: A retrospective single-center study
Xue-Yan Lin, Yi Zeng, Zheng-Chao Zhang, Zhi-Hui Lin, Lu-Chuan Chen, Zai-Sheng Ye
Xue-Yan Lin, Zhi-Hui Lin, Department of Gastroenterology, Fujian Provincial Hospital, Fujian Medical University Provincial of Clinical Medicine, Fuzhou 350001, Fujian Province, China
Yi Zeng, Lu-Chuan Chen, Zai-Sheng Ye, Department of Gastrointestinal Surgical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, Fujian Province, China
Zheng-Chao Zhang, Department of Emergency Surgery, Fujian Provincial Hospital, Fujian Medical University Provincial of Clinical Medicine, Fuzhou 350001, Fujian Province, China
Author contributions: Lin XY, Zeng Y, and Zhang ZC contributed equally to the work; Lin XY, Zeng Y, and Zhang ZC designed the study, collected and analyzed the data, and wrote the manuscript; Lin ZH, Chen LC, and Ye ZS made contributions to conception, design, and coordination of the study and gave final approval of the version to be published; All authors read and approved the final manuscript.
Institutional review board statement: The Ethics Committee of Fujian Provincial Hospital approved the study (K2021-02-007).
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zai-Sheng Ye, PhD, Attending Doctor, Surgical Oncologist, Teacher, Department of Gastrointestinal Surgical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, No. 420 Fuma Road, Fuzhou 350014, Fujian Province, China. flyingengel@sina.cn
Received: December 6, 2021
Peer-review started: December 6, 2021
First decision: April 16, 2022
Revised: April 25, 2022
Accepted: June 30, 2022
Article in press: June 30, 2022
Published online: August 7, 2022
Processing time: 239 Days and 21.8 Hours
ARTICLE HIGHLIGHTS
Research background

The incidence of hypertriglyceridemic acute pancreatitis (HTG-AP) has increased yearly, but updated population-based estimates on the incidence of HTG-AP are lacking. Reducing serum triglyceride (TG) levels quickly is crucial in the early treatment of HTG-AP. Currently, there are many treatments to reduce TG levels, but there is still a lack of authoritative guidelines.

Research motivation

We wanted to explore appropriate treatments to block the progression of HTG-AP.

Research objectives

To explore the clinical characteristics to reduce the missed diagnosis rate of HTG-AP and to identify the patients who would develop severe acute pancreatitis early. To compare the clinical outcomes of intravenous insulin (INS) and hemoperfusion (HP) and guide the choice of treatment for patients.

Research methods

We retrospectively reviewed the incidence and clinical characteristics of 371 patients with HTG-AP in our hospital from the past 10 years. Then, 219 patients who met the inclusion and exclusion criteria were further screened and divided to different groups according to grades of severity of HTG-AP and treatments. Multivariate logistic regression analyses were used to identify the independent risk factors for severe HTG-AP. Propensity score matching was used to compare the clinical outcomes of INS and HP.

Research results

The incidence of HTG-AP increased by approximately 2.6 times during the 10 years and ranged from 8.4% to 22.3% (8.4% in April 2012–March 2013 and 22.3% in April 2020–March 2021). Multivariate logistic regression analysis confirmed that high C-reactive protein [P = 0.005, odds ratio (OR) = 1.011, 95%CI: 1.003-1.019], low calcium (P = 0.003, OR = 0.016, 95%CI: 0.001-0.239), and low albumin (P = 0.023, OR = 0.821, 95%CI: 0.693-0.973) were risk factors of severe HTG-AP. After propensity score matching with sex, age, grades of severity, and baseline TG, there was a significant decrease in serum TG in patients treated with INS (P < 0.0001) and HP (P = 0.0001) within 48 h. However, the clearance rate of TG and length of stay did not differ between the two groups.

Research conclusions

The incidence of HTG-AP exhibited a significant increase. Patients with mild and moderately severe acute pancreatitis can be treated with INS safely and effectively without HP.

Research perspectives

Identifying patients with a severe tendency at the early stage of HTG-AP and choosing cost-effective treatments is the future direction of this research.