Severe hypertriglyceridemia (> 20 mmol/L) was associated with a 13-fold increased risk of acute pancreatitis (HR 13.55) compared to normal concentrations (≤ 1.7 mmol/L).
Cohort (n=1,530,441)
Yes
Does elevated plasma triglyceride concentration increase the risk of acute pancreatitis, chronic pancreatitis, diabetes, myocardial infarction, and mortality in a general population?
Severe hypertriglyceridemia (>20 mmol/L) is exponentially associated with acute and chronic pancreatitis, new diabetes, and mortality, but not myocardial infarction, which is only associated with moderate elevations.
Hazard Ratio: 13.55 (95% CI 9.15–20.06)
Absolute Event Rate: 3.5% vs 0.3%
BACKGROUND: Assessing the spectrum of disease risk associated with hypertriglyceridemia is needed to inform potential benefits from emerging triglyceride lowering treatments. We sought to examine the associations between a full range of plasma triglyceride concentration with five clinical outcomes. METHODS: We used linked data from primary and secondary care for 15 M people, to explore the association between triglyceride concentration and risk of acute pancreatitis, chronic pancreatitis, new onset diabetes, myocardial infarction and all-cause mortality, over a median of 6-7 years follow up. RESULTS: Triglyceride concentration was available for 1,530,411 individuals (mean age 56·6 ± 15·6 years, 51·4% female), with a median of 1·3 mmol/L (IQR: 0.9.to 1.9). Severe hypertriglyceridemia, defined as > 10 mmol/L, was identified in 3289 (0·21%) individuals including 620 with > 20 mmol/L. In multivariable analyses, a triglyceride concentration > 20 mmol/L was associated with very high risk for acute pancreatitis (Hazard ratio (HR) 13·55 (95% CI 9·15-20·06)); chronic pancreatitis (HR 25·19 (14·91-42·55)); and high risk for diabetes (HR 5·28 (4·51-6·18)) and all-cause mortality (HR 3·62 (2·82-4·65)) when compared to the reference category of ≤ 1·7 mmol/L. An association with myocardial infarction, however, was only observed for more moderate hypertriglyceridaemia between 1.7 and 10 mmol/L. We found a risk interaction with age, with higher risks for all outcomes including mortality among those ≤ 40 years compared to > 40 years. CONCLUSIONS: We highlight an exponential association between severe hypertriglyceridaemia and risk of incident acute and chronic pancreatitis, new diabetes, and mortality, especially at younger ages, but not for myocardial infarction for which only moderate hypertriglyceridemia conferred risk.
Patel et al. (Thu,) conducted a cohort in Hypertriglyceridemia (n=1,530,441). Severe hypertriglyceridemia (> 20 mmol/L) vs. Normal triglyceride concentration (≤ 1.7 mmol/L) was evaluated on Incident acute pancreatitis (HR 13.55, 95% CI 9.15-20.06). Severe hypertriglyceridemia (> 20 mmol/L) was associated with a 13-fold increased risk of acute pancreatitis (HR 13.55) compared to normal concentrations (≤ 1.7 mmol/L).