An increased risk for acute pancreatitis among ethnic minorities was associated with very high levels of triglycerides, especially in those with alcohol abuse and gallstones, according to new research published in Endocrine Practice.
“Early detection and counseling on behavioral risk factors in patients with severe hypertriglyceridemia may help in reduction of pancreatitis risk,” Ambika Amblee, MD, of the division of diabetes and endocrinology at the John H. Stroger, Jr. Hospital of Cook County in Chicago, and colleagues wrote. “The predictive modelling suggested in this study, if externally validated, may be a useful tool for individualizing therapy in such patients.”
Given several knowledge gaps on the link between triglyceride levels and pancreatitis, especially regarding prevalence among ethnic minorities, Amblee and colleagues retrospectively reviewed data on 1,157 patients with severe hypertriglyceridemia (triglyceride levels above 1,000 mg/dL) who received treatment at their urban safety-net hospital system, which cares for a diverse racial community. The overall cohort (mean age, 49.2 years; 75.6% men) included 38.4% Hispanics, 31.6% African Americans, 22.7% Caucasians, 5.7% Asians and 1.6 % Pacific Islanders.
A total of 9.2% of patients received a diagnosis of hypertriglyceridemic acute pancreatitis, and they were significantly younger than those without a diagnosis (41.3 vs. 50 years; P < .001), for reasons the researchers said were unclear.
Patients with triglyceride levels exceeding 2,000 mg/dL carried a 4.3-fold increased risk for pancreatitis vs. those with triglyceride levels between 1,000 and 1,999 mg/dL (22% vs. 5.1%), which validates the Endocrine Society's suggested cut-off, investigators noted.
In addition to triglyceride levels above 2,000 mg/dL (OR = 4.8; 95% CI, 3.1-7.4), independent risk factors included excessive alcohol consumption (OR = 3.9; 95% CI, 2.5-6) and gallstone disease (OR = 3.9; 95% CI, 1.4-10.8).
Patients with triglyceride levels below 2,000 mg/dL and no risk factors had 2% prevalence of pancreatitis vs. 33.6% in those with triglycerides above 2,000 mg/dL and one additional risk factor.
“The findings of the study might help risk stratify patients with severe hypertriglyceridemia in the outpatient setting to assess their risk for developing acute pancreatitis,” the study authors concluded. “It may also have therapeutic implications and help the clinician to decide on the urgency and intensity of management of severe hypertriglyceridemia based on the patient’s risk.” – by Adam Leitenberger
Disclosures: Frank reports no relevant financial disclosures.