title: Lipid metabolism in patients with chronic hyperglycemia after an episode of acute pancreatitis.
abstract: BACKGROUND
  The importance of dyslipidemia is well recognized in the context of both risk factor for acute pancreatitis and prognostic factor for its in-hospital outcomes. With a growing appreciation of post-pancreatitis diabetes mellitus, there is a need to catalogue changes in lipid metabolism after hospitalization due to an acute pancreatitis attack and their associations with glucose metabolism.
  
  
  OBJECTIVE
  To investigate lipid metabolism in patients with impaired glucose homeostasis following acute pancreatitis.
  
  
  METHODS
  There were two study groups: newly diagnosed chronic hyperglycemia or normoglycemia after acute pancreatitis. During the fasting state, venous blood samples were collected to analyse markers of lipid metabolism (triglycerides, glycerol, low density lipoprotein, high density lipoprotein, total cholesterol, free fatty acids, and apolipoprotein-B) and glucose metabolism (HbA1c, insulin, index of adipose tissue insulin resistance (Adipo-IR), and HOMA-IR). Binary logistic and linear regression analyses were conducted, and potential confounders were adjusted for in multivariate analyses.
  
  
  RESULTS
  The study included 64 patients with normoglycemia and 19 - with chronic hyperglycemia. Glycerol was significantly associated with the development of chronic hyperglycemia in both unadjusted (p=0.02) and adjusted (p=0.006) models. Triglycerides were significantly associated with the development of chronic hyperglycemia in adjusted (p=0.019) model. Other markers of lipid metabolism did not differ significantly between the two groups. None of the markers of lipid metabolism was significantly associated with Adipo-IR or HOMA-IR.
  
  
  CONCLUSIONS
  Overall, patients with chronic hyperglycemia after acute pancreatitis appear to have a lipid profile indicative of an up-regulation of lipolysis, which is not significantly affected by either general or adipose tissue-specific insulin resistance.
authors.affiliation: Department of Surgery, University of Auckland, New Zealand.
authors.forename: Nicola A
authors.initials: NA
authors.lastname: Gillies
authors.affiliation: Department of Surgery, University of Auckland, New Zealand.
authors.forename: Sayali A
authors.initials: SA
authors.lastname: Pendharkar
authors.affiliation: Department of Surgery, University of Auckland, New Zealand.
authors.forename: Ruma G
authors.initials: RG
authors.lastname: Singh
authors.affiliation: Department of Surgery, University of Auckland, New Zealand.
authors.forename: Varsha M
authors.initials: VM
authors.lastname: Asrani
authors.affiliation: Department of Surgery, University of Auckland, New Zealand. Electronic address: max.petrov@gmail.com.
authors.forename: Maxim S
authors.initials: MS
authors.lastname: Petrov
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000209:etiology* / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000503:physiopathology*; D007333:Insulin Resistance; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications*; D011379:Prognosis
keywords: Acute pancreatitis; Chronic hyperglycemia; Insulin resistance; Lipid metabolism; Post-pancreatitis diabetes mellitus