Key result
Triglycerides exceeding 10 mmol/L linked to steep acute pancreatitis risk, but chylomicronaemia lowers this threshold.
Why the study?
Hypertriglyceridaemia is the third most common cause of acute pancreatitis and a leading cause of recurrence, with risk rising steeply above approximately 10 mmol/L (≈885 mg/dL).
This review summarizes current and emerging strategies, including RNA-targeted therapies, for managing and preventing hypertriglyceridaemia-associated acute pancreatitis.
Alerts clinicians to pancreatitis risk below 10 mmol/L with chylomicronaemia; leaves open optimal prevention strategies.
Hypertriglyceridaemia is the third most common aetiology of acute pancreatitis and a leading cause of recurrence in specialized lipid clinics. The risk of acute pancreatitis rises steeply once triglycerides exceed approximately 10 mmol/L (≈885 mg/dL). Still, clinically meaningful risk may occur at lower levels in the presence of chylomicronaemia, metabolic stress, or pregnancy. This mini-review synthesizes contemporary evidence on epidemiology, mechanistic links between triglyceride-rich lipoproteins and pancreatic injury, and the practical distinction between secondary (acquired) and genetic drivers of severe hypertriglyceridaemia. We summarize acute management strategies aimed at rapid triglyceride reduction (including insulin-based approaches and therapeutic plasma exchange in selected scenarios) and focus on long-term prevention of recurrence through lifestyle interventions, correction of secondary contributors, and triglyceride-lowering pharmacotherapy. Finally, we discuss emerging RNA-targeted therapies against apolipoprotein C-III and angiopoietin-like 3, which are reshaping prevention strategies for familial and persistent chylomicronaemia and may reduce pancreatitis burden in the highest-risk phenotypes.
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Fogacci et al. (2026) conducted a review in Hypertriglyceridaemia-Associated Acute Pancreatitis. Hypertriglyceridaemia increases the risk of acute pancreatitis steeply once triglycerides exceed approximately 10 mmol/L, requiring rapid reduction and long-term prevention strategies.
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