Effects of stepwise lipid-controlled enteral nutrition on lipids and nutrition in hyperlipidemic acute pancreatitis with colorectal cancer

Abstract

BACKGROUND

Hyperlipidemic acute pancreatitis (HLAP) combined with colorectal cancer presents a dual burden of metabolic inflammation and tumor consumption. Serum triglycerides (TGs) is the core trigger of HLAP, while colorectal cancer exacerbates malnutrition and lipid disorders. Traditional enteral nutrition adopts fixed lipid ratios, failing to balance TG control with adequate nutritional support. Based on dynamic TG monitoring and lipid metabolism principles, we hypothesize that a stepwise lipid-controlled enteral nutrition regimen, adjusting fat composition and energy ratio according to TG thresholds, will effectively reduce TG, improve lipid profiles, and optimize nutritional status in these complex patients.

AIM

To determine the effects of stepwise lipid-controlled enteral nutrition on lipids and nutrition in HLAP with colorectal cancer.

METHODS

We investigated one hundred patients with HLAP and colon cancer (January 2022 to December 2025) divided into two groups. Controls received routine enteral nutrition. The observation group received stepwise lipid-controlled enteral nutrition, with fat ratio and formula adjusted by TG levels. Outcomes included TG, lipid panel [total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)], nutritional markers [albumin (ALB), prealbumin (PA), transferrin (TRF), arm muscle circumference (AMC)], symptom relief time, and complications, measured before and on days 3 and 7 of intervention.

RESULTS

After intervention, the observation group had lower TG levels than controls (day 3: 7.29 ± 2.37 mmol/L vs 12.61 ± 2.58 mmol/L; day 7: 4.75 ± 1.14 mmol/L vs 7.58 ± 2.16 mmol/L), better lipid profiles [day 3: HDL-C (0.87 ± 0.25 mmol/L vs 0.64 ± 0.22 mmol/L), LDL-C (2.38 ± 0.35 mmol/L vs 2.17 ± 0.47 mmol/L); day 7: TC (4.19 ± 0.54 mmol/L vs 3.86 ± 0.56 mmol/L), HDL-C (1.28 ± 0.37 mmol/L vs 0.96 ± 0.32 mmol/L), LDL-C (3.27 ± 0.42 mmol/L vs 2.84 ± 0.49 mmol/L)], and superior nutritional improvements [day 3: ALB (33.86 ± 3.06 g/L vs 32.26 ± 2.93 g/L) , PA (214.37 ± 27.93 mg/L vs 192.53 ± 24.06 mg/L) , TRF (1.76 ± 0.24 g/L vs 1.70 ± 0.25 g/L); day 7: ALB (38.26 ± 2.83 g/L vs 35.28 ± 2.68 g/L), PA (251.74 ± 31.65 mg/L vs 228.15 ± 27.43 mg/L), TRF (2.14 ± 0.28 g/L vs 1.86 ± 0.26 g/L), AMC (22.29 ± 2.36 cm vs 21.14 ± 2.30 cm)]. Clinical symptoms resolved faster, and complication rates were lower (12% vs 36%, P = 0.005).

CONCLUSION

Individualized stepwise lipid-controlled enteral nutrition effectively lowers TG, enhances lipid metabolism and nutrition, relieves symptoms, and reduces complications in HLAP-colorectal cancer patients.

Keywords: Hyperlipidemic pancreatitis; Colon cancer; Stepwise lipid control; Personalized nutrition; Enteral nutrition; Triglycerides

Core Tip: This intervention study demonstrates that a stepwise lipid-controlled enteral nutrition protocol, dynamically adjusted based on triglyceride (TG) thresholds, significantly reduces hypertriglyceridemia, optimizes concurrent lipid and protein metabolism, and accelerates clinical recovery in patients with hyperlipidemic acute pancreatitis and colorectal cancer. The findings advocate for integrating dynamic lipid monitoring into nutritional management for such complex comorbidities and propose a “TG-guided, protein-prioritized” enteral nutrition model, addressing a critical gap in the metabolic support of oncological patients with acute metabolic inflammation.