Hypertriglyceridemia-associated acute pancreatitis: Response to continuous insulin infusion

Autor: Ambika Amblee, Sara Elizabeth T. Yap, Vishnu Priya Pulipati, Leon Fogelfeld, Hafeez Shaka, Bettina Tahsin
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Physiology
medicine.medical_treatment
Gastroenterology
Biochemistry
Insulin infusion
Endocrinology
Medical Conditions
Medicine and Health Sciences
Insulin
Ethnicities
Serum triglycerides
Hispanic People
Hypertriglyceridemia
Multidisciplinary
Organic Compounds
Monosaccharides
Middle Aged
Hospitals
Chemistry
Intensive Care Units
Physiological Parameters
Physical Sciences
Acute pancreatitis
Medicine
Female
Research Article
Adult
medicine.medical_specialty
Endocrine Disorders
Science
Carbohydrates
Gastroenterology and Hepatology
Intensive care
Diabetes mellitus
Internal medicine
medicine
Diabetes Mellitus
Humans
Obesity
Triglycerides
Retrospective Studies
Diabetic Endocrinology
business.industry
Organic Chemistry
Body Weight
Chemical Compounds
Biology and Life Sciences
medicine.disease
Hormones
Health Care
Glucose
Pancreatitis
Health Care Facilities
Metabolic Disorders
Alcohols
People and Places
Population Groupings
business
Zdroj: PLoS ONE, Vol 16, Iss 11, p e0260495 (2021)
PLoS ONE
ISSN: 1932-6203
Popis: Objective To assess the response of serum triglycerides (TG) to continuous insulin infusion (CII) in adults with hypertriglyceridemia-associated acute pancreatitis (HTGP). Methods Retrospective analysis of TG response to standardized CII therapy in 77 adults admitted to intensive care with TG >1000 mg/dL and HTGP. Results Participants had initial TG 3869.0 [2713.5, 5443.5] mg/dL and were 39.3 ± 9.7 years old, 66.2% males, 58.4% Hispanic, BMI 30.2 [27.0, 34.8] kg/m2, 74.0% with diabetes mellitus (DM) and 50.6% with excess alcohol use. TG-goal, defined as ≤1,000 ± 100 mg/dL, was achieved in 95%. Among the 73 TG-goal achievers (responders), 53.4% reached TG-goal in 2), DM prevalence (56.4 vs 94.1%), and reached TG-50% (half of respective initial TG) faster (12.0 [6.0, 17.0] vs 18.5 [13.0, 32.8] hours). Those with DM (n = 57) vs non-DM (n = 20) were obese (31.4 [28.0, 35.6] vs 27.8 [23.6, 30.3] kg/m2), took longer to reach TG-final (41.0 [25.0, 60.5] vs 14.5 [12.5, 25.5] hours) and used more daily insulin (1.7 [1.3, 2.1] vs 1.1 [0.5, 1.9] U/kg/day). Among those with DM, the rapid responders had higher daily use of insulin vs slow responders 1.9 [1.4, 2.3] vs 1.6 [1.1, 1.8] U/kg/day. All results significant. In multivariable analysis, predictors of faster TG response were absence of DM, lower BMI and initial TG. Conclusion CII was effective in reaching TG-goal in 95% of patients with HTGP. Half achieved TG-goal within 36 hours. Presence of DM, higher BMI and initial TG slowed the time to reach TG-goal. These baseline parameters and rate of decline to TG-50% may be real-time indicators to initiate and adjust the CII for quicker response.
Databáze: OpenAIRE
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