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Acute Pancreatitis in a Cohort of 129 Patients Referred for Severe Hypertriglyceridemia

Lloret Linares, Célia MD*; Pelletier, Anne Laure MD; Czernichow, Sébastien MD, PhD‡§; Vergnaud, Anne Claire PhD; Bonnefont-Rousselot, Dominique PharmD, PhD; Levy, Philippe MD, PhD; Ruszniewski, Philippe MD, PhD; Bruckert, Eric MD, PhD

doi: 10.1097/MPA.0b013e31816074a1
Original Articles
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Objectives: 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.

From the *Nutrition, Pitié Salpêtrière Hospital (AP-HP), Paris; †Hepatogastroenterology, Beaujon Hospital (AP-HP), Clichy; ‡INSERM, U557, CRNH IdF, Bobigny; §Public Health Department, Avicenne Hospital (AP-HP), Bobigny; and ∥Lipid Biochemistry Laboratory and ¶Endocrinology, Pitié Salpêtrière Hospital (AP-HP), Paris, France.

Received for publication May 11, 2007; accepted October 29, 2007.

Reprints: Célia Lloret Linares, MD, Department of Nutrition, Pitié Salpêtrière Hospital (AP-HP), Paris, France (e-mail: celialloret@yahoo.fr).

© 2008 Lippincott Williams & Wilkins, Inc.