Dynamic changes of lipid profile in severe hypertriglyceridemia-induced acute pancreatitis patients under double filtration plasmapheresis: a retrospective observational study

Autor: Huijun Zheng, Guo Feng, Yongjun Lin, Zhihua Lu, Xiaoling Wang, Donghai Wang, Na Yang, Yueliang Chen
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Very low-density lipoprotein
Endocrinology
Diabetes and Metabolism
Cholesterol
VLDL
Clinical Biochemistry
Gastroenterology
chemistry.chemical_compound
0302 clinical medicine
Endocrinology
High-density lipoprotein
lcsh:RC620-627
Hypertriglyceridemia
medicine.diagnostic_test
Plasmapheresis
Middle Aged
Prognosis
Lipid profile
lcsh:Nutritional diseases. Deficiency diseases
030220 oncology & carcinogenesis
Low-density lipoprotein
Acute pancreatitis
Female
030211 gastroenterology & hepatology
lipids (amino acids
peptides
and proteins)
Adult
medicine.medical_specialty
Clinical nutrition
03 medical and health sciences
Internal medicine
medicine
Humans
Triglycerides
Retrospective Studies
Apolipoprotein A-I
Cholesterol
business.industry
Research
Cholesterol
HDL
Biochemistry (medical)
Cholesterol
LDL
medicine.disease
Severe hypertriglyceridemia-induced acute pancreatitis
Double filtration plasma apheresis
Pancreatitis
chemistry
Lipidomics
business
Biomarkers
Lipoprotein
Zdroj: Lipids in Health and Disease, Vol 19, Iss 1, Pp 1-7 (2020)
Lipids in Health and Disease
Popis: Background: In this study, we aimed to investigate the dynamic changes of lipid profile under double filtration plasmapheresis (DFPP) in severe hypertriglyceridemia-induced acute pancreatitis (sHTGP) patients and ascertain whether these changes were associated with the prognosis of the disease.Methods: This retrospective study was conducted at a tertiary critical care center in China. We included sHTGP patients who were admitted within 72h after AP onset. All the sHTGP patients received DFPP within 24h after admission. Lipid profile changes was measured in 47 patients with sHTGP on admission, consecutive 4 days after DFPP and at discharge. According to the TG levels in the first day after DFPP, we divided patients into two group: non-target (TG>5.6mmol/L) and target group (TG ≤5.6mmol/L). Propensity score matching was used to investigate association between TG-lowering effect and the prognosis. Linear regression analysis on four models was used to determine the relationship between other lipid parameters and the outcome.Results: Except for low density lipoprotein, all the parameters of lipid profile at disease onset showed significant difference from their normal levels. The median serum triglyceride (TG) level of the sHTGP patients was 42.9 mmol/L on admission. In the first day after DFPP, serum TG, cholesterol (TC) and very low density lipoprotein decreased significantly, and the high-density lipoprotein (HDL) as well as apoprotein A1 increased meanwhile. TG continued to fall for the following three days and the other indicators held steady. After propensity score matching, the hospitalization duration was significantly lower in the target group (14.5 [13.0, 16.0] vs 8.0 [6.0, 15.3], P=0.035). Linear regression analysis revealed that the levels of HDL were negatively associated with the duration of hospitalization in three adjusted models.Conclusion: There was distinct fluctuation of the lipid profile upon the burst of sHTGP and the parameters changed significantly in the first day after DFPP. Among these parameters, HDL may serve as a biomarker for disease prognosis in patients with sHTGP. Moreover, reaching the TG-lowering target of 5.6mmol/L may shorten hospitalization duration.
Databáze: OpenAIRE
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