Acute pancreatitis in a cohort of 129 patients referred for severe hypertriglyceridemia.
OBJECTIVE
The aim of this study was to assess retrospectively the prevalence and the predictive factors of acute pancreatitis (AP) in a population of patients referred in our endocrinology department for evaluation of very high triglyceride (TG) levels.


METHODS
One hundred twenty-nine patients (119 with type IV phenotypes and 10 with type V phenotypes according to Fredrickson's classification) were referred to our hospital between 2000 and 2005.


RESULTS
Twenty-six subjects (20.2% of the population) presented with AP. This population was significantly younger at diagnosis of hyperlipidemia (32 vs 40 years, P < 0.001) and at age of investigation (43 vs 48 years, P = 0.05) and had maximum TG levels greater than the population without AP (44.7 vs 24.5, P < 0.001). Subjects of the third tertile of TG levels had a 4.0-fold increased risk (95% confidence interval, 1.3-12.3) of AP compared with the first tertile. Severe pancreatitis (need for intensive care, C-reactive protein >150 mg/L, or Balthazar score >C) was observed in 71.5% of the patients.


CONCLUSIONS
Twenty percent of patients with severe hypertriglyceridemia experience at least 1 attack of AP. Pancreatitis seems to occur in young patients at higher levels of TG than previously thought (85% of patients >30 g/L) and is associated with a severe clinical course.
Lloret Linares
Célia
C
Nutrition, Pitié Salpêtrière Hospital, AP-HP, Paris, France. celialloret@yahoo.fr
Pelletier
Anne Laure
AL
Czernichow
Sébastien
S
Vergnaud
Anne Claire
AC
Bonnefont-Rousselot
Dominique
D
Levy
Philippe
P
Ruszniewski
Philippe
P
Bruckert
Eric
E
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006953:Hyperlipoproteinemia Type IV / Q000150:complications / Q000453:epidemiology*; D006954:Hyperlipoproteinemia Type V / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index