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Cited by 66Pancreatitis Pathology and TreatmentLipid metabolism and disordersGallbladder and Bile Duct Disorders

Severe hypertriglyceridemia and factors associated with acute pancreatitis in an integrated health care system

Rashid, Nazia, Sharma, Puza P., Scott, Ronald D., Lin, Kathy J., Toth, Peter P.·2016·Journal of Clinical Lipidology
DOI 10.1016/j.jacl.2016.02.019
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Abstract

Objective To evaluate patient characteristics, treatment patterns, comorbidities, and risk factors associated with the development of acute pancreatitis (AP) in patients with severe hypertriglyceridemia (HTG) in an integrated health care delivery system.Methods We identified a retrospective cohort of severe HTG patients with a fasting triglyceride level ≥ 1000 mg/dL during January 1, 2007 to June 30, 2013 (index date) in an integrated health care delivery system. Patients were aged ≥18 years on index date and had 12 months of continuous membership and drug eligibility before the index date and during postindex including index date. Baseline patient characteristics, comorbidities, and risk factors were evaluated during 12-month preindex. Outcomes such as development of AP, treatment patterns, adherence to index therapy, and change in triglyceride (TG) laboratory levels were evaluated during postindex. Descriptive statistics were used to identify differences between patients developing AP vs no development of AP. A stepwise multivariate logistic regression and backward elimination method were used to assess statistically significant predictive factors associated with development of AP vs no AP.Results We identified 5550 patients with severe HTG, and 5.4% of these patients developed AP during postindex. Patients were mostly male (≥70%) in both groups; however, younger in the AP group (45 years ± 10.6) vs no AP group (50 years ± 11.4) with P value < .0001. The AP group had higher baseline Charslon Comorbidity Index score, alcohol abuse history (42.2%), any pancreatitis history (51.5%), diabetes (47%), and hypertension (55%), vs the no AP group (P values < .05). Patients in the AP group had higher baseline mean TG levels (2148, SD ± 1578) vs the no AP group (1559, SD ± 861), P value < .0001. Over 50% of the patients were prescribed their index therapy by a primary care provider. Predictive factors associated with the development of AP included younger age, alcohol use, and prior history of any pancreatitis, hypertension, renal disease stage 4, and other prescriber specialty. From parameters estimates, for each 100 mg/dL unit of increase in the TG level above 1000 mg/dL, there was a 3 percent increase in risk of developing AP.Conclusions Patients with severe HTG are at a higher risk of developing AP. A number of comorbidities, risk factors, and baseline TG levels are associated with an increased incidence of AP. Patients with severe HTG are underdiagnosed, undertreated and are nonadherent to their index lipid therapy. There is a need to better define optimal approaches to treating severe HTG so as to reduce the incidence of AP. Economic studies are also needed to evaluate the burden of AP on various health care systems.

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  • Fibrates, omega-3 fatty acids, and niacin have not been tested for their effectiveness in reducing the incidence of acute pancreatitis.

    “These drugs, however, have not been tested for their effectiveness in reducing the incidence of acute pancreatitis. 33”

    From Olezarsen, Acute Pancreatitis, and Familial Chylomicronemia Syndrome (2024) · cites this paper as [33]

  • Observational data indicate that acute pancreatitis incidence rises by about 3% for each 100 mg per deciliter increase in triglycerides above 1000 mg per deciliter.

    “Observational data sug-gest that the incidence of acute pancreatitis increases approximately 3% for every increment of 100 mg per deciliter in triglyceride levels over 1000 mg per deciliter 34”

    From Volanesorsen and Triglyceride Levels in Familial Chylomicronemia Syndrome (2019) · cites this paper as [34]

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Authors
Rashid, N., Sharma, P. P., Scott, R. D., Lin, K. J., & Toth, P. P.
Affiliations
  • Kaiser Permanente (US)
  • Novartis (United States) (US)
  • Johns Hopkins University (US)
Corresponding author
Rashid, Nazia
ORCID
Venue
Journal of Clinical Lipidology
Publisher
Elsevier BV
Published
2016-07
Volume
10
Issue
4
Pages
880-890
ISSN
  • 1876-4789 (ISSN-L)
  • 1933-2874
DOI
10.1016/j.jacl.2016.02.019
OpenAlex
W2298025084
Cited by
66
References
18
Citations by year
2026: 6 · 2025: 5 · 2024: 11 · 2023: 4 · 2022: 5 · 2021: 7 · 2020: 9 · 2019: 8 · 2018: 7 · 2017: 2 · 2016: 1
FWCI
6.64
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of clinical lipidology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gallbladder and Bile Duct Disorders
Keywords
severe hypertriglyceridemia, acute pancreatitis, risk factors, triglyceride levels, alcohol consumption, hypertension, kidney disease, prescriber specialty, primary care prescribing, integrated care delivery, comorbidities, treatment patterns, medication adherence, triglyceride-lowering therapy
MeSH terms
Acute Disease, Aged, Delivery of Health Care, Fasting, Female, Humans, Male, Middle Aged, Pancreatitis, Patient Compliance, Prognosis, Retrospective Studies, Risk Factors, Triglycerides, Hypertriglyceridemia, Cohort Studies, Comorbidity

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