title: Coagulopathy and the prognostic potential of D-dimer in hyperlipidemia-induced acute pancreatitis.
abstract: BACKGROUND
  Coagulopathy and its association with disease severity in hyperlipidemia (HL)- and non-hyperlipidemia (NHL)-induced acute pancreatitis (AP) are not clear. The present study was to evaluate the relationship between coagulation homeostasis and AP.
  
  
  METHODS
  This study included 106 AP patients admitted to our hospital between October 2011 and January 2013. Stratified by disease severity, the patients were divided into two groups: a mild AP (MAP) group (n=69); and a moderately severe AP (MSAP) group (n=37). Based on disease etiology, there were 31 HL-induced AP (HLP) cases and 75 NHL-induced AP (NHLP) cases. The HLP and NHLP groups were compared for parameters of coagulation homeostasis, lipid metabolism, and disease severity. Correlations between disease severity and levels of D-dimer and protein C were investigated, and the prognostic potential of D-dimer was evaluated.
  
  
  RESULTS
  Compared with MAP patients, MSAP patients showed higher levels of D-dimer and lower levels of protein C. HLP patients had higher protein C levels than NHLP patients. Both D-dimer and protein C levels were significantly associated with the disease severity, not the disease etiology. D-dimer levels correlated positively with low density lipoprotein cholesterol levels and performed well as a sensitive and specific predictor of disease severity in AP patients, especially in HLP patients.
  
  
  CONCLUSIONS
  The coagulation homeostasis is different between HLP and NHLP patients, and HL may be a contributing factor for thrombosis and fibrinolysis in HLP. D-dimer may be a robust marker of disease severity in HLP.
authors.affiliation: Department of Gastroenterology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China. haojianyucyyy@sina.com.
authors.forename: Ning
authors.initials: N
authors.lastname: Yang
authors.forename: Dong-Lei
authors.initials: DL
authors.lastname: Zhang
authors.forename: Jian-Yu
authors.initials: JY
authors.lastname: Hao
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D002681:China; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D011237:Predictive Value of Tests; D011486:Protein C / Q000032:analysis; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; C036309:fibrin fragment D