{"title":"Patients Admitted with Acute pancreatitis and Dyslipidemia Affected by Non-Alcoholic Fatty Liver Disease are Associated with Worse Clinical Outcomes","authors":"","doi":"10.1016/j.jacl.2024.04.057","DOIUrl":null,"url":null,"abstract":"<div><h3>Background/Synopsis</h3><p>Individuals with NAFLD may have alterations in lipid metabolism, insulin resistance, and an increased risk of dyslipidemia, all of which can contribute to the development of acute pancreatitis. Dyslipidemia, particularly elevated triglycerides and low-density lipoprotein cholesterol (LDL-C), is often seen in individuals with NAFLD. Insulin resistance and metabolic syndrome are common underlying factors.</p></div><div><h3>Objective/Purpose</h3><p>There is limited scientific evidence of clinical outcomes of NAFLD in patients admitted with acute pancreatitis & dyslipidemia. Hence, we sought to investigate this population.</p></div><div><h3>Methods</h3><p>We queried National Inpatient Sample between 2017-2020 for adult patients who were hospitalized with acute pancreatitis & dyslipidemia with NAFLD. The primary outcome was inpatient mortality. The secondary outcomes were cardiogenic shock, cardiac arrest, gastrointestinal bleeding (GIB), acute kidney injury (AKI), intubation, length of stay (LOS) and total hospital charge. Multivariable logistic regression analysis was used to estimate clinical outcomes. P-value < 0.05 was significant.</p></div><div><h3>Results</h3><p>There were 574,269 hospitalizations with acute pancreatitis and dyslipidemia where 29,324 (5.1%) had NAFLD. NAFLD and non-NAFLD cohorts were with mean age of 61.5 vs. 60 yrs; males 54.5% vs 56.2%; Caucasians 65.0% both; HTN 49% vs 56%; HF 18.8% vs 12%; obesity 27% vs 24%; Metabolic Syndrome 9.6% vs 8.7%; DKA 3.9% vs 4.9%; AF 24.4% vs 23.5%; AKI 38% vs 21.8%; obesity 30.3% vs 29.3%; ACS 6.6% vs 2.8%; acute respiratory failure 17.8% vs 6.4%; history of stroke 0.9% vs 0.4%; COPD 15% vs 13.5%; alcohol use 19.9% vs 18.5%, respectively. NAFLD cohort had significantly higher mortality and worse clinical outcomes (Table 1).</p></div><div><h3>Conclusions</h3><p>NAFLD group demonstrated significantly higher mortality, worse clinical outcomes and resource utilization. Patients were older, obese, female, same Caucasian population, with more frequent HF, AF, ACS and alcohol use. NAFLD is associated with greater risk for cardiovascular events, renal failure, GIB, and ICU care. NAFLD is an important predictor of adverse outcomes in acute pancreatitis & dyslipidemia population. Further research is necessary to describe long-term outcomes.</p></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of clinical lipidology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1933287424001041","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
Abstract
Background/Synopsis
Individuals with NAFLD may have alterations in lipid metabolism, insulin resistance, and an increased risk of dyslipidemia, all of which can contribute to the development of acute pancreatitis. Dyslipidemia, particularly elevated triglycerides and low-density lipoprotein cholesterol (LDL-C), is often seen in individuals with NAFLD. Insulin resistance and metabolic syndrome are common underlying factors.
Objective/Purpose
There is limited scientific evidence of clinical outcomes of NAFLD in patients admitted with acute pancreatitis & dyslipidemia. Hence, we sought to investigate this population.
Methods
We queried National Inpatient Sample between 2017-2020 for adult patients who were hospitalized with acute pancreatitis & dyslipidemia with NAFLD. The primary outcome was inpatient mortality. The secondary outcomes were cardiogenic shock, cardiac arrest, gastrointestinal bleeding (GIB), acute kidney injury (AKI), intubation, length of stay (LOS) and total hospital charge. Multivariable logistic regression analysis was used to estimate clinical outcomes. P-value < 0.05 was significant.
Results
There were 574,269 hospitalizations with acute pancreatitis and dyslipidemia where 29,324 (5.1%) had NAFLD. NAFLD and non-NAFLD cohorts were with mean age of 61.5 vs. 60 yrs; males 54.5% vs 56.2%; Caucasians 65.0% both; HTN 49% vs 56%; HF 18.8% vs 12%; obesity 27% vs 24%; Metabolic Syndrome 9.6% vs 8.7%; DKA 3.9% vs 4.9%; AF 24.4% vs 23.5%; AKI 38% vs 21.8%; obesity 30.3% vs 29.3%; ACS 6.6% vs 2.8%; acute respiratory failure 17.8% vs 6.4%; history of stroke 0.9% vs 0.4%; COPD 15% vs 13.5%; alcohol use 19.9% vs 18.5%, respectively. NAFLD cohort had significantly higher mortality and worse clinical outcomes (Table 1).
Conclusions
NAFLD group demonstrated significantly higher mortality, worse clinical outcomes and resource utilization. Patients were older, obese, female, same Caucasian population, with more frequent HF, AF, ACS and alcohol use. NAFLD is associated with greater risk for cardiovascular events, renal failure, GIB, and ICU care. NAFLD is an important predictor of adverse outcomes in acute pancreatitis & dyslipidemia population. Further research is necessary to describe long-term outcomes.
背景/简介非酒精性脂肪肝患者可能会出现脂质代谢改变、胰岛素抵抗和血脂异常风险增加,所有这些都可能导致急性胰腺炎的发生。非酒精性脂肪肝患者通常会出现血脂异常,尤其是甘油三酯和低密度脂蛋白胆固醇(LDL-C)升高。胰岛素抵抗和代谢综合征是常见的潜在因素。目标/目的有关急性胰腺炎合并血脂异常患者非酒精性脂肪肝临床结局的科学证据有限。因此,我们试图对这一人群进行调查。方法我们查询了 2017-2020 年间全国住院患者样本,以了解因急性胰腺炎&;血脂异常伴非酒精性脂肪肝住院的成年患者的情况。主要结果是住院死亡率。次要结果为心源性休克、心脏骤停、消化道出血(GIB)、急性肾损伤(AKI)、插管、住院时间(LOS)和住院总费用。多变量逻辑回归分析用于估计临床结果。结果共有 574,269 例因急性胰腺炎和血脂异常住院的患者,其中 29,324 例(5.1%)患有非酒精性脂肪肝。非酒精性脂肪肝患者和非酒精性脂肪肝患者的平均年龄为 61.5 岁 vs. 60 岁;男性 54.5% vs. 56.2%;白种人 65.0%;高血压 49% vs. 56%;高血脂 18.8% vs. 12%;肥胖 27% vs. 24%;代谢综合征 9.6% vs. 8.7%;DKA 3.9% vs. 4.9%;房颤 24.4% vs 23.5%;AKI 38% vs 21.8%;肥胖 30.3% vs 29.3%;ACS 6.6% vs 2.8%;急性呼吸衰竭 17.8% vs 6.4%;中风史 0.9% vs 0.4%;COPD 15% vs 13.5%;饮酒 19.9% vs 18.5%。非酒精性脂肪肝组的死亡率明显更高,临床预后更差(表1)。患者年龄较大、肥胖、女性,同为高加索人种,更常见心房颤动、房颤、急性心肌梗死和酗酒。非酒精性脂肪肝与心血管事件、肾功能衰竭、GIB和重症监护病房护理的更高风险相关。非酒精性脂肪肝是急性胰腺炎和血脂异常人群不良预后的重要预测因素。有必要开展进一步研究,以描述长期结果。
期刊介绍:
Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.