Elevated serum triglycerides are independently associated with persistent organ failure in acute pancreatitis

Haq Nawaz, Efstratios Koutroumpakis, Jeffrey Easler, Adam Slivka, David C. Whitcomb, Vijay Prem Singh, Dhiraj Yadav, Georgios I. Papachristou

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: Hypertriglyceridemia (HTG) represents a major health problem with prevalence exceeding 30% in the U.S. The present study aims to assess the effect of elevated serum triglyceride (TG) levels on the severity of acute pancreatitis (AP).

METHODS: Prospectively enrolled AP patients were categorized into normal, mild, moderate, and severe/very severe categories based on their TG levels and compared in respect to demographics, comorbidities, and clinical outcomes. Multivariate analysis determined whether elevated TG levels were independently associated with persistent organ failure.

RESULTS: Two hundred and one out of 400 AP patients had serum TGs measured within 72 h of presentation, of which 115 had normal TG levels and 86 HTG (20 mild, 41 moderate, and 25 severe/very severe). Patients with HTG were of younger age (44 vs. 52 years), predominantly male (65% vs. 45%), obese (57% vs. 34%), diabetic (38% vs. 17%), and developed more frequently persistent organ failure (40% vs. 17%) compared with those with normal TGs (P<0.02). The rate of persistent organ failure increased proportionally with HTG severity grades (17% when normal TGs, 30% in mild, 39% in moderate, and 48% in severe/very severe HTG, Ptrend<0.001). On multivariate analysis controlling for age, gender, body mass index, diabetes, and alcohol etiology, moderate HTG (odds ratio (OR), 2.6; P=0.04) and severe/very severe HTG (OR, 4.9; P=0.009) were independently associated with persistent organ failure.

CONCLUSIONS: Elevated serum TGs in AP patients are independently and proportionally correlated with persistent organ failure regardless of etiology. TG-mediated lipotoxicity may be an attractive target to design novel interventions for severe AP.

Original languageEnglish (US)
Pages (from-to)1497-1503
Number of pages7
JournalThe American journal of gastroenterology
Volume110
Issue number10
DOIs
StatePublished - Oct 1 2015

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Hypertriglyceridemia
Pancreatitis
Triglycerides
Serum
Multivariate Analysis
Odds Ratio
Comorbidity
Body Mass Index
Alcohols
Demography
Health

ASJC Scopus subject areas

  • Gastroenterology

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Elevated serum triglycerides are independently associated with persistent organ failure in acute pancreatitis. / Nawaz, Haq; Koutroumpakis, Efstratios; Easler, Jeffrey; Slivka, Adam; Whitcomb, David C.; Singh, Vijay Prem; Yadav, Dhiraj; Papachristou, Georgios I.

In: The American journal of gastroenterology, Vol. 110, No. 10, 01.10.2015, p. 1497-1503.

Research output: Contribution to journalArticle

Nawaz, H, Koutroumpakis, E, Easler, J, Slivka, A, Whitcomb, DC, Singh, VP, Yadav, D & Papachristou, GI 2015, 'Elevated serum triglycerides are independently associated with persistent organ failure in acute pancreatitis', The American journal of gastroenterology, vol. 110, no. 10, pp. 1497-1503. https://doi.org/10.1038/ajg.2015.261
Nawaz, Haq ; Koutroumpakis, Efstratios ; Easler, Jeffrey ; Slivka, Adam ; Whitcomb, David C. ; Singh, Vijay Prem ; Yadav, Dhiraj ; Papachristou, Georgios I. / Elevated serum triglycerides are independently associated with persistent organ failure in acute pancreatitis. In: The American journal of gastroenterology. 2015 ; Vol. 110, No. 10. pp. 1497-1503.
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abstract = "OBJECTIVES: Hypertriglyceridemia (HTG) represents a major health problem with prevalence exceeding 30{\%} in the U.S. The present study aims to assess the effect of elevated serum triglyceride (TG) levels on the severity of acute pancreatitis (AP).METHODS: Prospectively enrolled AP patients were categorized into normal, mild, moderate, and severe/very severe categories based on their TG levels and compared in respect to demographics, comorbidities, and clinical outcomes. Multivariate analysis determined whether elevated TG levels were independently associated with persistent organ failure.RESULTS: Two hundred and one out of 400 AP patients had serum TGs measured within 72 h of presentation, of which 115 had normal TG levels and 86 HTG (20 mild, 41 moderate, and 25 severe/very severe). Patients with HTG were of younger age (44 vs. 52 years), predominantly male (65{\%} vs. 45{\%}), obese (57{\%} vs. 34{\%}), diabetic (38{\%} vs. 17{\%}), and developed more frequently persistent organ failure (40{\%} vs. 17{\%}) compared with those with normal TGs (P<0.02). The rate of persistent organ failure increased proportionally with HTG severity grades (17{\%} when normal TGs, 30{\%} in mild, 39{\%} in moderate, and 48{\%} in severe/very severe HTG, Ptrend<0.001). On multivariate analysis controlling for age, gender, body mass index, diabetes, and alcohol etiology, moderate HTG (odds ratio (OR), 2.6; P=0.04) and severe/very severe HTG (OR, 4.9; P=0.009) were independently associated with persistent organ failure.CONCLUSIONS: Elevated serum TGs in AP patients are independently and proportionally correlated with persistent organ failure regardless of etiology. TG-mediated lipotoxicity may be an attractive target to design novel interventions for severe AP.",
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T1 - Elevated serum triglycerides are independently associated with persistent organ failure in acute pancreatitis

AU - Nawaz, Haq

AU - Koutroumpakis, Efstratios

AU - Easler, Jeffrey

AU - Slivka, Adam

AU - Whitcomb, David C.

AU - Singh, Vijay Prem

AU - Yadav, Dhiraj

AU - Papachristou, Georgios I.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - OBJECTIVES: Hypertriglyceridemia (HTG) represents a major health problem with prevalence exceeding 30% in the U.S. The present study aims to assess the effect of elevated serum triglyceride (TG) levels on the severity of acute pancreatitis (AP).METHODS: Prospectively enrolled AP patients were categorized into normal, mild, moderate, and severe/very severe categories based on their TG levels and compared in respect to demographics, comorbidities, and clinical outcomes. Multivariate analysis determined whether elevated TG levels were independently associated with persistent organ failure.RESULTS: Two hundred and one out of 400 AP patients had serum TGs measured within 72 h of presentation, of which 115 had normal TG levels and 86 HTG (20 mild, 41 moderate, and 25 severe/very severe). Patients with HTG were of younger age (44 vs. 52 years), predominantly male (65% vs. 45%), obese (57% vs. 34%), diabetic (38% vs. 17%), and developed more frequently persistent organ failure (40% vs. 17%) compared with those with normal TGs (P<0.02). The rate of persistent organ failure increased proportionally with HTG severity grades (17% when normal TGs, 30% in mild, 39% in moderate, and 48% in severe/very severe HTG, Ptrend<0.001). On multivariate analysis controlling for age, gender, body mass index, diabetes, and alcohol etiology, moderate HTG (odds ratio (OR), 2.6; P=0.04) and severe/very severe HTG (OR, 4.9; P=0.009) were independently associated with persistent organ failure.CONCLUSIONS: Elevated serum TGs in AP patients are independently and proportionally correlated with persistent organ failure regardless of etiology. TG-mediated lipotoxicity may be an attractive target to design novel interventions for severe AP.

AB - OBJECTIVES: Hypertriglyceridemia (HTG) represents a major health problem with prevalence exceeding 30% in the U.S. The present study aims to assess the effect of elevated serum triglyceride (TG) levels on the severity of acute pancreatitis (AP).METHODS: Prospectively enrolled AP patients were categorized into normal, mild, moderate, and severe/very severe categories based on their TG levels and compared in respect to demographics, comorbidities, and clinical outcomes. Multivariate analysis determined whether elevated TG levels were independently associated with persistent organ failure.RESULTS: Two hundred and one out of 400 AP patients had serum TGs measured within 72 h of presentation, of which 115 had normal TG levels and 86 HTG (20 mild, 41 moderate, and 25 severe/very severe). Patients with HTG were of younger age (44 vs. 52 years), predominantly male (65% vs. 45%), obese (57% vs. 34%), diabetic (38% vs. 17%), and developed more frequently persistent organ failure (40% vs. 17%) compared with those with normal TGs (P<0.02). The rate of persistent organ failure increased proportionally with HTG severity grades (17% when normal TGs, 30% in mild, 39% in moderate, and 48% in severe/very severe HTG, Ptrend<0.001). On multivariate analysis controlling for age, gender, body mass index, diabetes, and alcohol etiology, moderate HTG (odds ratio (OR), 2.6; P=0.04) and severe/very severe HTG (OR, 4.9; P=0.009) were independently associated with persistent organ failure.CONCLUSIONS: Elevated serum TGs in AP patients are independently and proportionally correlated with persistent organ failure regardless of etiology. TG-mediated lipotoxicity may be an attractive target to design novel interventions for severe AP.

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