Incidence of pancreatitis, secondary causes, and treatment of patients referred to a specialty lipid clinic with severe hypertriglyceridemia: a retrospective cohort study

Lipids in Health and Disease

Research

Gordon A Francis¹  Catalin Taraboanta¹  Supna Sandhu¹  Jiri Frohlich²  Ahmad Al-Sarraf² 

[1] Department of Medicine, Healthy Heart Program Prevention Clinic, UBC James Hogg Research Centre, Providence Heart + Lung Institute, St. Paul's Hospital, University of British Columbia, 1081 Burrard St., V6Z 1Y6, Vancouver, BC, Canada;Department of Pathology and Laboratory Medicine, Healthy Heart Program Prevention Clinic, UBC James Hogg Research Centre, Providence Heart + Lung Institute, St. Paul's Hospital, University of British Columbia, 1081 Burrard St., V6Z 1Y6, Vancouver, BC, Canada;

关键词: Hypertriglyceridemia;    triglycerides;    pancreatitis;    dysglycemia;    diabetes;    fibrates;   

DOI  :  10.1186/1476-511X-10-157

 received in 2011-07-18, accepted in 2011-09-11,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundSevere hypertriglyceridemia (HTG) is one cause of acute pancreatitis, yet the level of plasma triglycerides likely to be responsible for inducing pancreatitis has not been clearly defined.Methods and ResultsA retrospective cohort study was conducted on patients presenting non-acutely to the Healthy Heart Program Lipid Clinic at St. Paul's Hospital with a TG level > 20 mM (1772 mg/dl) between 1986 and 2007. Ninety-five patients with TG > 20 mM at the time of referral were identified, in who follow up data was available for 84. Fifteen patients (15.8%), with a mean outpatient TG level of 38.1 mM, had a history of acute pancreatitis. Among 91 additional patients with less severe HTG, none had a history of pancreatitis when TG were between 10 and 20 mM. Among patients with TG > 20 mM on presentation, 8 (8.5%), with a mean TG level of 67.8 mM, exhibited eruptive xanthomata. A diet high in carbohydrates and fats (79%) and obesity (47.6%) were the two most frequent secondary causes of HTG at initial visit. By 2009, among patients with follow up data 53% exhibited either pre-diabetes or overt Type 2 diabetes mellitus. Upon referral only 23 patients (24%) were receiving a fibrate as either monotherapy or part of combination lipid-lowering therapy. Following initial assessment by a lipid specialist this rose to 84%, and remained at 67% at the last follow up visit.ConclusionsThese results suggest hypertriglyceridemia is unlikely to be the primary cause of acute pancreatitis unless TG levels are > 20 mM, that dysglycemia, a diet high in carbohydrates and fats, and obesity are the main secondary causes of HTG, and that fibrates are frequently overlooked as the drug of first choice for severe HTG.

【 授权许可】

Unknown   
© Sandhu et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.