Obesity rates are rising worldwide. Acute pancreatitis is also on the rise. The authors of the current study followed prospectively about 120,000 individuals. As expected, they found a high correlation between BMI and acute pancreatitis events. Investigators also observed that hypertriglyceridemia could explain about 22-30% of the relationship between obesity and pancreatitis.
The results of the study, although not new, confirm prior research and knowledge that obesity leads to insulin resistance, which in turn elevates blood triglyceride concentration. Hypertriglyceridemia is a well-known specific cause of acute pancreatitis, especially when triglyceride measurements are above 500 mg/dL.
Clinically, it is essential to screen obesity patients for hypertriglyceridemia. A fasting lipid panel is a simple and inexpensive laboratory test that can provide significant insights into the patient’s risk of insulin resistance and pancreatitis.
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J C E M
Prospective
October 2019
Objective
The incidence of acute pancreatitis is rising worldwide and currently no curative treatment exist. Clarifying preventable risk factors are important for reduction of morbidity and mortality from acute pancreatitis. In this study, we tested the hypothesis that the risk of acute pancreatitis associated with BMI is partly mediated through higher triglycerides.
Design
We included 118,085 individuals from two prospective cohort studies, the Copenhagen City Heart Study and the Copenhagen General Population Study, with BMI measured at baseline. Diagnosis of acute pancreatitis was hospitalization or death due to acute pancreatitis, assessed from the national Danish registries.
Results
Higher BMI was associated with higher risk of acute pancreatitis with a multivariable adjusted hazard ratio of as shown below when compared to individuals with BMI of 18.5-24.9.
- 29% (p=0.001) of the association between BMI and risk of acute pancreatitis in the age and sex adjusted model, and
- 22% (p=0.008) in the multivariable adjusted model.
Conclusion
Higher BMI is associated with higher risk of acute pancreatitis in individuals from the general population, partly mediated through higher triglycerides.
This indicates a potential for preventing acute pancreatitis by reducing BMI and triglycerides in individuals with high values.
- 1.4 (p<0.05) for BMI of 25-29.9
- 2.1 (p<0.05) for BMI of 30-34.9
- 2.8 (p<0.05) for BMI>35
Triglycerides mediated:
- 29% (p=0.001) of the association between BMI and risk of acute pancreatitis in the age and sex adjusted model, and
- 22% (p=0.008) in the multivariable adjusted model.
Conclusion
Higher BMI is associated with higher risk of acute pancreatitis in individuals from the general population, partly mediated through higher triglycerides.
This indicates a potential for preventing acute pancreatitis by reducing BMI and triglycerides in individuals with high values.