Retrospective Study
Copyright ©The Author(s) 2022.
World J Gastroenterol. Aug 7, 2022; 28(29): 3946-3959
Published online Aug 7, 2022. doi: 10.3748/wjg.v28.i29.3946
Table 1 Clinical characteristics of hypertriglyceridemic acute pancreatitis
Characteristic
All (n = 371)
Sex, n (%)
Male247 (66.6)
Female124 (33.4)
Age, yr39.86 ± 10.20
BMI (kg/m2)25.99 ± 3.18
Causes, n (%)203 (54.7)
Diet (high fatty acid)127 (34.2)
Drinking (beer)55 (14.8)
Mixed21 (5.7)
Complications, n (%)
Diabetes mellitus115 (31.0)
Hypertension62 (16.7)
Fatty liver disease336 (90.6)
Pregnancy11 (3.0)
Recurrence, n (%)122 (32.9)
Grades of severity, n (%)
MAP63 (17.0)
MSAP208 (56.1)
SAP100 (26.9)
Improved Marshall score1.30 ± 1.77
Organ failure, n (%)117 (31.5)
MCTSI score5.00 ± 1.83
Lipid-lowering treatment, n (%)
Intravenous insulin144 (38.8)
HP32 (8.6)
CRRT/HP + CRRT77 (20.8)
Only anti-lipemic118 (31.8)
Baseline TG, mg/dL2544.59 ± 2305.37
Baseline AMY (nUNL)5.00 ± 6.47
> UNL, n (%)297 (80.1)
≥ 3UNL, n (%)174 (46.9)
Admission to ICU, n (%)126 (34.0)
Death, n (%)11 (3.0)
Table 2 Comparisons of clinical characteristics and laboratory parameters with different grades of severity of hypertriglyceridemic acute pancreatitis
Characteristic
All (n = 219)
MAP group (n = 29)
MSAP group (n = 114)
SAP group (n = 76)
P value
Sex, n (%)0.111
Male140 (63.9)23 (79.3)67 (58.8)50 (65.8)
Female79 (36.1)6 (20.7)47 (41.2)26 (34.2)
Age, yr38.92 ± 10.0238.66 ± 9.7338.96 ± 10.1238.96 ± 10.120.941
BMI (kg/m2)26.13 ± 3.3026.20 ± 1.5625.58 ± 3.5428.51 ± 2.970.097
Complications, n (%)
Diabetes mellitus109 (49.8)14 (48.3)58 (50.9)37 (48.7)0.982
Fatty liver disease205 (93.6)25 (86.2)106 (93.0)74 (97.4)0.112
Lipid-lowering treatment, n (%)< 0.001
Intravenous insulin84 (38.4)14 (48.3)69 (60.5)1 (1.3)
HP32 (14.6)1 (3.4)26 (22.8)5 (6.6)
CRRT/HP + CRRT60 (27.4)0 (0.0)1 (0.9)59 (77.6)
Only anti-lipemic43 (19.6)14 (48.3)18 (15.8)11 (14.5)
Improved Marshall score1.00 (0.00, 3.00)0.00 (0.00, 0.00)0.00 (0.00, 1.00)3.00 (3.00, 4.75)< 0.001
MCTSI score5.11 ± 1.702.14 ± 0.925.14 ± 1.066.18 ± 1.35< 0.001
Baseline TG, mg/dL2713.82 ± 2458.651895.15 ± 1685.172480.80 ± 2040.4583386.29 ± 3081.510.035
Baseline AMY (nUNL)2.92 (1.43, 6.41)2.81 (1.47, 5.21)2.22 (0.98, 5.08)5.28 (2.21, 8.66)< 0.001
CRP, mg/L196.36 ± 121.97143.17 ± 97.51178.65 ± 103.25247.12 ± 143.73< 0.001
Albumin, g/L32.66 ± 5.9936.48 ± 4.9634.46 ± 5.1628.49 ± 5.16< 0.001
TBIL, mmol/L16.60 (10.80, 22.90)18.91 (13.02, 23.68)15.35 (10.69, 22.46)16.57 (10.60, 24.92)0.511
ALT, U/L20.00 (13.60, 30.70)21.30 (14.90, 35.75)20.25 (13.00, 31.93)19.75 (14.03, 27.30)0.648
AST, U/L25.00 (17.50, 39.50)21.30 (17.00, 28.05)20.00 (16.08, 30.63)36.55 (25.00, 56.80)< 0.001
Total cholesterol, mmol/L8.58 ± 4.567.47 ± 2.968.82 ± 4.538.64 ± 5.060.522
HDL-C, mmol/L0.82 (0.61, 1.10)0.88 (0.75, 1.17)0.86 (0.66, 1.16)0.69 (0.52, 0.99)0.241
LDL-C, mmol/L2.92 ± 1.553.77 ± 1.412.91 ± 1.582.62 ± 1.460.003
Glucose, mmol/L10.50 ± 3.649.47 ± 3.7010.34 ± 3.5411.13 ± 3.690.100
Urea nitrogen, mmol/L4.73 ± 3.314.56 ± 1.633.66 ± 1.766.40 ± 4.64< 0.001
Creatinine, μmol/L83.03 ± 66.4871.90 ± 18.0365.46 ± 19.11113.63 ± 103.46< 0.001
Calcium, mmol/L1.93 ± 0.312.16 ± 0.182.00 ± 0.211.75 ± 0.37< 0.001
WBC, × 109/L11.67 ± 4.1011.22 ± 3.6411.99 ± 4.0611.37 ± 4.330.351
PLT, × 109/L200.19 ± 69.19194.69 ± 73.58208.67 ± 65.17189.57 ± 72.510.159
Hb, g/L141.11 ± 24.52143.69 ± 19.12136.87 ± 22.76146.49 ± 27.780.010
STSH, mIU/L0.28 (0.16, 0.65)0.49 (0.28, 0.98)0.28 (0.14, 0.66)0.24 (0.16, 0.62)0.188
FT3, pmol/L2.29 ± 1.002.90 ± 0.772.36 ± 0.862.89 ± 1.180.018
FT4, pmol/L12.56 ± 3.7012.83 ± 2.1012.88 ± 3.9512.11 ± 3.680.302
Admission to ICU, n (%)98 (44.7)1 (3.4)27 (23.7)70 (92.1)< 0.001
Death, n (%)9 (4.1)0 (0.0)0 (0.0)9 (11.8)< 0.001
Table 3 Factors associated with severe hypertriglyceridemic acute pancreatitis according to multivariate logistic regression analysis
Variable
B
OR
OR (95%CI)
P value
Baseline TG0.0231.023(0.991-1.056)0.159
Baseline AMY0.3451.412(0.916-2.175)0.118
CRP0.1101.011(1.003-1.019)0.005
Albumin-0.1970.821(0.693-0.973)0.023
AST0.0181.018(0.975-1.063)0.423
LDL-C-0.1730.814(0.556-1.272)0.412
Urea nitrogen-0.3340.709(0.462-1.086)0.114
Creatinine0.0251.026(0.988-1.065)0.186
Calcium-4.1520.016(0.001-0.239)0.003
Hb0.0081.008(0.975-1.043)0.621
FT3-1.3240.266(0.055-1.281)0.099
Table 4 Comparisons of clinical characteristics and laboratory parameters with different treatment between intravenous insulin and hemoperfusion before and after propensity score matching
Characteristic
Entire cohort
P value
PSM
P value
INS group (n = 84)
HP Group (n = 32)
INS group (n = 26)
HP group (n = 26)
Sex, n (%)0.6260.184
Male51 (60.7)21 (65.6)20 (76.9)16 (61.5)
Female33 (39.3)11 (34.4)6 (23.1)10 (38.5)
Age, yr39.99 ± 10.3636.44 ± 11.600.96536.81 ± 10.7936.42 ± 10.100.895
Grades of severity, n (%)0.0020.755a
MAP14 (16.7)1 (3.1)1 (3.8)1 (3.8)
MSAP69 (82.1)26 (81.3)25 (96.2)25 (96.2)
SAP1 (1.2)5 (15.6)0 (0.0)0 (0.0)
Improved Marshall score0.00 (0.00, 1.00)1.00 (1.00, 2.00)< 0.0010.00 (0.00, 1.00)1.00 (0.00, 1.00)0.186a
MCTSI score4.67 ± 1.595.75 ± 0.84< 0.0015.15 ± 1.295.62 ± 0.800.127a
Baseline TG, mg/dL2493.20 ± 1958.063443.88 ± 1676.310.0373484.64 ± 2275.2483264.91 ± 2375.370.734a
Treated TG within 48 h, mg/dL946.25 ± 769.051145.60 ± 699.050.2051108.39 ± 856.761040.16 ± 686.650.753
Clearance rate of TG within 48 h, %47.65 ± 34.6463.91 ± 23.320.00557.24 ± 33.7056.38 ± 33.610.927a
CRP, mg/L184.75 ± 99.84198.43 ± 94.000.552214.612 ± 119.22198.28 ± 97.090.629
Albumin, g/L34.05 ± 4.8132.50 ± 6.390.21934.56 ± 5.0332.53 ± 6.580.218
TBIL, mmol/L17.80 ± 8.9619.83 ± 13.610.43918.70 ± 9.3820.87 ± 14.410.523
ALT, U/L24.55 ± 17.7723.15 ± 18.150.70524.58 ± 16.6921.81 ± 16.470.550
AST, U/L25.70 ± 14.2330.85 ± 26.870.18724.84 ± 12.4032.10 ± 29.440.252
Total cholesterol, mmol/L8.38 ± 3.898.93 ± 4.370.5119.84 ± 4.918.52 ± 4.580.318
Glucose, mmol/L11.08 ± 3.6510.83 ± 3.420.73911.71 ± 2.7410.07 ± 3.220.057
Urea nitrogen, mmol/L4.02 ± 1.863.83 ± 2.270.6523.54 ± 1.763.34 ± 1.940.688
Creatinine, mmol/L63.73 ± 18.2367.72 ± 24.010.33865.00 ± 12.3367.00 ± 23.360.702
Calcium, mmol/L1.98 ± 0.251.90 ± 0.280.1002.03 ± 0.231.89 ± 0.310.063
WBC, × 109/L11.79 ± 4.2012.33 ± 4.370.54112.40 ± 4.0012.51 ± 4.440.920
PLT, × 109/L205.39 ± 68.44204.34 ± 65.980.941201.66 ± 59.77197.38 ± 57.910.795
Hb, g/L137.48 ± 23.67138.12 ± 27.600.902143.44 ± 19.50135.38 ± 27.500.230
Length of stay, d11.88 ± 6.3711.93 ± 6.010.96513.04 ± 7.9212.35 ± 6.400.730
Death, n (%)0 (0.0)0 (0.0)0 (0.0)0 (0.0)