Acute pancreatitis events among patients with severe hypertriglyceridemia: A retrospective study

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology Pub Date : 2025-05-01 DOI:10.1016/j.jacl.2025.04.007

Eric Young PhD, Monica McClain PhD, Oiza Aliu PharmD

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引用次数: 0

Abstract

Funding

This study was funded by Ionis Pharmaceuticals.

Background/Synopsis

Severe hypertriglyceridemia (sHTG), caused by genetic disorders like familial chylomicronemia syndrome or secondary causes like diabetes, obesity, renal disease, hypothyroidism, and certain medications, can lead to acute pancreatitis (AP), a potentially life-threatening complication. Contemporary data on sHTG-associated AP events and their recurrence are limited.

Objective/Purpose

To describe AP event patterns in patients with sHTG.

Methods

This was a retrospective descriptive cohort study of AP events among patients with sHTG (triglyceride levels [TG] ≥ 500 mg/dL) using electronic medical records from the TrinetX Dataworks USA network between January 2015 – September 2024. Patients were stratified by TG levels ≥ 500 - ≤ 880 and > 880 mg/dL. Patients had at least a 12-month baseline period before the index event (first TG ≥ 500 mg/dL), at least two TG measurements ≥ 500 mg/dL during the patient identification period (January 2016 – September 2023) and were followed at least 12 months after the index event. AP was defined based on ICD-10 code (K85) and stratified as 0, 1, ≥ 1, and ≥ 2 during follow-up. Triglyceride levels and medications were defined using LOINC and RxNorm codes respectively.

Results

A total of 65,510 patients had sHTG (≥ 500 - ≤ 880 vs. > 880 cohort; 52,417 vs. 13,153). Of these, 1,287 patients (1.9%) had ≥ 1 AP events. The median follow-up time was 54.3 months vs. 53.1 months for the ≥ 500 - ≤ 880 vs. > 880 cohort. The mean age (SD) was 49.6 (14.2) years, and 32.9% were female. A higher proportion of patients in the > 880 cohort (4.0%) had ≥ 1 AP events than in the ≥ 500 - ≤ 880 cohort (1.5%). Patients with ≥ 1 AP events were more likely to have diabetes (51.3% vs 34.0%), and renal disease (13.3% vs 9.1%), compared with patients with no AP events. The mean number of AP events among patients with at least one event was greater than 3 for both cohorts.

Conclusions

This study highlights the increasing rates of AP with higher triglyceride levels (> 880 mg/dL) and the prevalence of secondary sHTG causes among sHTG patients with AP. Further, the results show that most patients with an initial AP event experience multiple AP events during the study period. The increasing burden of AP in sHTG patients emphasizes the need for effective strategies and management to prevent its occurrence.

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严重高甘油三酯血症患者的急性胰腺炎事件：一项回顾性研究

本研究由Ionis制药公司资助。背景/简介严重高甘油三酯血症（sHTG）是由遗传性疾病如家族性乳糜小铁血症综合征或继发原因如糖尿病、肥胖、肾病、甲状腺功能减退和某些药物引起的，可导致急性胰腺炎（AP），这是一种潜在的危及生命的并发症。关于shtg相关AP事件及其复发的当代数据有限。目的/目的探讨sHTG患者的AP事件模式。方法：采用2015年1月至2024年9月来自TrinetX Dataworks USA网络的电子病历，对sHTG（甘油三酯水平[TG]≥500 mg/dL）患者的AP事件进行回顾性描述性队列研究。患者按TG水平≥500 ~≤880和>；880 mg / dL。患者在指标事件发生前至少有12个月的基线期（第一次TG≥500mg /dL），在患者识别期间（2016年1月至2023年9月）至少有两次TG测量≥500mg /dL，并在指标事件发生后至少随访12个月。根据ICD-10编码（K85）定义AP，随访时分为0、1、≥1、≥2。分别使用LOINC和RxNorm代码定义甘油三酯水平和药物。结果65,510例患者发生sHTG(≥500 ~≤880 vs. >；880组;52,417对13,153)。其中，1287例患者（1.9%）发生≥1次AP事件。中位随访时间为54.3个月，≥500 -≤880组为53.1个月；880组。平均年龄（SD） 49.6（14.2）岁，女性占32.9%。较高比例的患者在>；880组（4.0%）发生≥1例AP事件，而≥500 -≤880组（1.5%）发生AP事件。与没有AP事件的患者相比，AP事件≥1次的患者更容易发生糖尿病（51.3% vs 34.0%）和肾脏疾病（13.3% vs 9.1%）。在两个队列中，至少发生一次AP事件的患者的平均AP事件数大于3次。结论：本研究强调甘油三酯水平升高会增加AP发生率(>；880 mg/dL)和继发性sHTG原因在sHTG合并AP患者中的患病率。此外，研究结果表明，大多数初始AP事件的患者在研究期间经历了多次AP事件。sHTG患者日益增加的AP负担强调需要有效的策略和管理来预防其发生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of clinical lipidology 医学-药学

CiteScore

7.00

自引率

6.80%

发文量

209

审稿时长

49 days

期刊介绍： Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. Sections of Journal of clinical lipidology will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.