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Inicio Gastroenterología y Hepatología (English Edition) Influence of enlarged waist circumference and hypertriglyceridemia in the severi...
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Vol. 46. Issue 10.
Pages 795-802 (December 2023)
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Vol. 46. Issue 10.
Pages 795-802 (December 2023)
Original article
Influence of enlarged waist circumference and hypertriglyceridemia in the severity of acute pancreatitis: A retrospective study
Influencia del aumento de la circunferencia de la cintura y la hipertrigliceridemia en la gravedad de la pancreatitis aguda: un estudio retrospectivo
Jean Félix Piñerúa-Gonsálveza,
Corresponding author
jeanfelixmedicina@hotmail.com

Corresponding author.
, María Lourdes Ruiz-Rebolloa, Rosanna del Carmen Zambrano-Infantinob, María Antonella Rizzo-Rodrígueza, Luis Fernández-Salazara
a Department of Gastroenterology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
b Department of Nuclear Medicine, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
Article information
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Tables (5)
Table 1. Patient baseline and clinical characteristics at admission in four phenotypes groups.
Table 2. Comparison of clinical outcomes in four phenotypes groups.
Table 3. Univariable and multivariable analysis of proposed predictors of organ failure in patients with acute pancreatitis.
Table 4. Univariable and multivariable analysis of proposed predictors of SIRS in patients with acute pancreatitis.
Table 5. Univariable and multivariable analysis of proposed predictors of local complications in patients with acute pancreatitis.
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Abstract
Introduction

Acute pancreatitis is a frequent inflammatory gastrointestinal disorder with high mortality rates in severe forms. An early evaluation of its severity is key to identify high-risk patients. This study assessed the influence of waist circumference together with hypertriglyceridemia on the severity of acute pancreatitis.

Methods

A retrospective study was performed, which included patients admitted with acute pancreatitis from March 2014 to March 2021. Patients were classified into four phenotype groups according to their waist circumference and triglyceride levels: normal waist circumference and normal triglycerides; normal waist circumference and elevated triglycerides; enlarged waist circumference and normal triglycerides; and enlarged waist circumference and triglycerides, namely hypertriglyceridemic waist (HTGW) phenotype. Clinical outcomes were compared among the groups.

Results

407 patients were included. Systemic inflammatory response syndrome (SIRS) and intensive care unit admission were most frequent among patients in the HTGW phenotype group, at 44.9% and 8.2%, respectively. The incidence of local complications was higher in the normal waist circumference with elevated triglycerides group (27%). On multivariable analysis, an enlarged waist circumference was related to an increase of 4% and 2% in the likelihood of developing organ failure and SIRS, respectively. Hypertriglyceridemia was an independent risk factor for both organ failure and local complications.

Conclusions

HTGW phenotype was significant related to developing of SIRS. It seems that an enlarged waist circumference has a greater role than hypertriglyceridemia in the development of SIRS. Obesity and hypertriglyceridemia were both independent risk factors for organ failure. Patients with hypertriglyceridemia were more likely to develop local complications.

Keywords:
Acute pancreatitis
Hypertriglyceridemia
Waist circumference
Organ failure
Local complications
Resumen
Introducción

La pancreatitis aguda es una patología frecuente con altas tasas de mortalidad en sus formas graves. Este estudio evaluó la influencia de la circunferencia de la cintura (CC) junto con la hipertrigliceridemia en la gravedad de la pancreatitis aguda.

Métodos

Se realizó un estudio retrospectivo que incluyó pacientes con pancreatitis aguda desde 2014 hasta 2021. Los pacientes se clasificaron en cuatro grupos fenotípicos según su CC y los niveles de triglicéridos: CC normal y triglicéridos normales, CC normal y triglicéridos elevados, CC aumentada y triglicéridos normales, y CC aumentada y triglicéridos elevados, es decir, el fenotipo cintura hipertrigliceridémica (HTGW).

Resultados

Se incluyeron 407 pacientes. El síndrome de respuesta inflamatoria sistémica (SIRS) y la admisión a la unidad de cuidados intensivos fueron más frecuentes entre los pacientes con fenotipo HTGW, en 44,9 y 8,2%, respectivamente. La incidencia de complicaciones locales fue mayor en el grupo de CC normal con triglicéridos elevados (27%). En el análisis multivariable, una CC aumentada se relacionó con un aumento de 4 y 2% en la probabilidad de desarrollar fallo orgánico y SIRS, respectivamente. La hipertrigliceridemia fue un factor de riesgo tanto para el fallo orgánico como para las complicaciones locales.

Conclusiones

El fenotipo HTGW se relacionó con el desarrollo de SIRS. Parece que una CC aumentada tiene un papel más importante que la hipertrigliceridemia en el desarrollo de SIRS. La obesidad y la hipertrigliceridemia fueron factores de riesgo independientes para el fallo orgánico. Los pacientes con hipertrigliceridemia tenían más probabilidades de desarrollar complicaciones locales.

Palabras clave:
Pancreatitis aguda
Hipertrigliceridemia
Circunferencia de cintura
Fallo orgánico
Complicaciones locales

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