BACKGROUND: Hypertriglyceridemia is the third most common cause of acute pancreatitis (AP). It has been shown that hypertriglyceridemia aggravates the severity and related complications of AP; however, detailed analyses of large cohorts are contradictory. Our aim was to investigate the dose-dependent effect of hypertriglyceridemia on AP. METHODS: AP patients over 18 years old who underwent triglyceride measurement within the initial three days were included into our cohort analysis from a prospective international, multicenter AP registry operated by the Hungarian Pancreatic Study Group. Data on 716 AP cases were analyzed. Six groups were created based on the highest triglyceride level (<1.7 mmol/l, 1.7-2.19 mmol/l, 2.2-5.59 mmol/l, 5.6-11.29 mmol/l, 11.3-22.59 mmol/l, ≥22.6 mmol/l). RESULTS: Hypertriglyceridemia (≥1.7 mmol/l) presented in 30.6% of the patients and was significantly and dose-dependently associated with younger age and male gender. In 7.7% of AP cases, hypertriglyceridemia was considered as a causative etiological factor (≥11.3 mmol/l); however, 43.6% of these cases were associated with other etiologies (alcohol and biliary). Hypertriglyceridemia was significantly and dose-dependently related to obesity and diabetes. The rates of local complications and organ failure and maximum CRP level were significantly and dose-dependently raised by hypertriglyceridemia. Triglyceride above 11.3 mmol/l was linked to a significantly higher incidence of moderately severe AP and longer hospital stay, whereas triglyceride over 22.6 mmol/l was significantly associated with severe AP as well. CONCLUSION: Hypertriglyceridemia dose-dependently aggravates the severity and related complications of AP. Diagnostic workup for hypertriglyceridemia requires better awareness regardless of the etiology of AP.

1st Department of Medicine Faculty of Medicine University of Szeged Szeged Hungary

1st Department of Medicine Medical School University of Pécs Pécs Hungary

1st Department of Paediatrics Faculty of Medicine Semmelweis University Budapest Hungary; Institute for Translational Medicine Szentágothai Research Center Medical School University of Pécs Pécs Hungary; Doctoral School of Theoretical Medicine Faculty of Medicine University of Szeged Szeged Hungary

Bajcsy Zsilinszky Hospital Budapest Hungary

Borsod Abaúj Zemplén County Hospital and University Teaching Hospital Miskolc Hungary

Centre for Translational Medicine 1st Department of Medicine Faculty of Medicine University of Szeged Szeged Hungary

Centrum Péče o Zažívací Trakt Vítkovická Nemocnice a s Ostrava Czech Republic

Consorci Sanitari Del Garraf Sant Pere de Ribes Barcelona Spain

County Emergency Clinical Hospital George Emil Palade University of Medicine Pharmacy Sciences and Technology of Târgu Mureș Târgu Mureș Romania

Department of Gastroenterology Bács Kiskun County Hospital Kecskemét Hungary

Department of Gastroenterology Dr Réthy Pál Hospital of County Békés Békéscsaba Hungary

Department of Internal Medicine Division of Gastroenterology Faculty of Medicine University of Debrecen Debrecen Hungary

Department of Transplantation and Liver Surgery University of Helsinki and Helsinki University Hospital Helsinki Finland; Department of Abdominal Surgery University of Helsinki and Helsinki University Hospital Helsinki Finland

Division of Translational Medicine 1st Department of Medicine Medical School University of Pécs Pécs Hungary

Dr Bugyi István Hospital Szentes Hungary

George Emil Palade University of Medicine Pharmacy Sciences and Technology of Târgu Mureș Târgu Mureș Romania

Hospital of Bezmialem Vakif University School of Medicine Istanbul Turkey

Institute for Translational Medicine Szentágothai Research Center Medical School University of Pécs Pécs Hungary

Institute for Translational Medicine Szentágothai Research Center Medical School University of Pécs Pécs Hungary; 1st Department of Medicine Medical School University of Pécs Pécs Hungary

Institute for Translational Medicine Szentágothai Research Center Medical School University of Pécs Pécs Hungary; Centre for Translational Medicine 1st Department of Medicine Faculty of Medicine University of Szeged Szeged Hungary

Institute for Translational Medicine Szentágothai Research Center Medical School University of Pécs Pécs Hungary; Centre for Translational Medicine 1st Department of Medicine Faculty of Medicine University of Szeged Szeged Hungary; Division of Translational Medicine 1st Department of Medicine Medical School University of Pécs Pécs Hungary; Hungarian Academy of Sciences University of Szeged Momentum Gastroenterology Multidisciplinary Research Group Szeged Hungary

Institute for Translational Medicine Szentágothai Research Center Medical School University of Pécs Pécs Hungary; Doctoral School of Theoretical Medicine Faculty of Medicine University of Szeged Szeged Hungary; Department of Gastroenterology Heim Pál Children's Hospital Budapest Hungary

Institute of Bioanalysis Medical School University of Pécs Pécs Hungary

Pándy Kálmán Hospital of County Békés Gyula Hungary

Saint Luke Clinical Hospital St Petersburg Russia

Szent György Teaching Hospital of County Fejér Székesfehérvár Hungary

Vilnius University Hospital Santaros Clinics Clinics of Abdominal Surgery Nephrourology and Gastroenterology Faculty of Medicine Vilnius University Vilnius Lithuania

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