A systematic review of the epidemiology and risk factors for severity and recurrence of hypertriglyceridemia-induced acute pancreatitis

Abstract This systematic review aims to comprehensively assess the epidemiology and identify risk factors associated with the severity and recurrence of hypertriglyceridemia-induced acute pancreatitis (HTG-AP). A search of PubMed, Web of Science, and Cochrane databases was conducted to identify all...

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Main Authors: Jiongdi Lu, Zhe Wang, Wentong Mei, Kaixin Peng, Liang Zhang, Gang Wang, Kedong Xu, Zheng Wang, Yunpeng Peng, Zipeng Lu, Xiaolei Shi, Guotao Lu, Li Wen, Feng Cao, Chinese Hypertriglyceridemia-Associated Pancreatitis Study Group (CHPSG)
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Language:English
Published: BMC 2025-05-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-03954-4
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author Jiongdi Lu
Zhe Wang
Wentong Mei
Kaixin Peng
Liang Zhang
Gang Wang
Kedong Xu
Zheng Wang
Yunpeng Peng
Zipeng Lu
Xiaolei Shi
Guotao Lu
Li Wen
Feng Cao
Chinese Hypertriglyceridemia-Associated Pancreatitis Study Group (CHPSG)
author_facet Jiongdi Lu
Zhe Wang
Wentong Mei
Kaixin Peng
Liang Zhang
Gang Wang
Kedong Xu
Zheng Wang
Yunpeng Peng
Zipeng Lu
Xiaolei Shi
Guotao Lu
Li Wen
Feng Cao
Chinese Hypertriglyceridemia-Associated Pancreatitis Study Group (CHPSG)
author_sort Jiongdi Lu
collection DOAJ
description Abstract This systematic review aims to comprehensively assess the epidemiology and identify risk factors associated with the severity and recurrence of hypertriglyceridemia-induced acute pancreatitis (HTG-AP). A search of PubMed, Web of Science, and Cochrane databases was conducted to identify all relevant randomized controlled trials (RCTs), prospective, or retrospective cohort studies on HTG-AP. Data related to epidemiology and risk factors for severity and recurrence of HTG-AP were extracted and analyzed. Seventy-seven studies met the inclusion criteria, comprising 1 RCT, 21 prospective studies, and 55 retrospective studies. A total of 56,617 acute pancreatitis (AP) patients were included, of which 19.99% were diagnosed with HTG-AP (n = 11,315). Compared to non-HTG-AP patients, HTG-AP patients were more likely to be male (68.7% vs. 57.3%) and younger (mean age 41.47 ± 4.32 vs. 50.25 ± 7.70 years). HTG-AP patients exhibited higher mortality rates (up to 20% vs. 15.2%), increased severity (8.3% to 100% vs. 3.8% to 47.2%), and higher recurrence rates (up to 64.8% vs. 23.3%). Analysis of temporal trends from 2002 to 2023 showed a range of HTG-AP prevalence in overall AP patients from 1.6% to 47.6%, with a slight upward trend that was not statistically significant (P = 0.1081). Regional analysis indicated relatively stable prevalence in North America (P = 0.5787), Europe (P = 0.0881), other regions (P = 0.738), while prevalence in China showed a significant increase (P = 0.0119). Thirteen studies investigated risk factors affecting HTG-AP severity, with elevated serum triglyceride (TG) levels associated with increased risk of complications such as pancreatic necrosis, systemic inflammatory response syndrome (SIRS), shock, and multi-organ failure. Additional factors including high neutrophil-to-lymphocyte ratio (NLR), elevated levels of amylase and C-reactive protein (CRP), hypocalcemia, and hypoalbuminemia were also implicated in HTG-AP severity. Smoking history, poor lipid control (TG > 3.1 mmol/L), or recurrent hypertriglyceridemia during follow-up were identified as potential predictors of HTG-AP recurrence. Our findings indicate a stable global prevalence of HTG-AP within AP patients, but a notable increase in China, possibly attributed to socio-economic and dietary factors.
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spelling doaj-art-e4a2ea60a5ac48ea870d285a96a0cbdf2025-08-20T02:32:03ZengBMCBMC Gastroenterology1471-230X2025-05-012511910.1186/s12876-025-03954-4A systematic review of the epidemiology and risk factors for severity and recurrence of hypertriglyceridemia-induced acute pancreatitisJiongdi Lu0Zhe Wang1Wentong Mei2Kaixin Peng3Liang Zhang4Gang Wang5Kedong Xu6Zheng Wang7Yunpeng Peng8Zipeng Lu9Xiaolei Shi10Guotao Lu11Li Wen12Feng Cao13Chinese Hypertriglyceridemia-Associated Pancreatitis Study Group (CHPSG)Department of General Surgery, Xuanwu Hospital, Capital Medical UniversityDepartment of General Surgery, Xuanwu Hospital, Capital Medical UniversityDepartment of General Surgery, Xuanwu Hospital, Capital Medical UniversityCenter for Biomarker Discovery and Validation, National Infrastructures for Translational Medicine (PUMCH), Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical CollegeDepartment of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical UniversityDepartment of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical UniversityDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong UniversityPancreas Center, The First Affiliated Hospital of Nanjing Medical UniversityPancreas Center, The First Affiliated Hospital of Nanjing Medical UniversityPancreatic Center, Department of Gastroenterology, Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou UniversityPancreatic Center, Department of Gastroenterology, Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou UniversityCenter for Biomarker Discovery and Validation, National Infrastructures for Translational Medicine (PUMCH), Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical CollegeDepartment of General Surgery, Xuanwu Hospital, Capital Medical UniversityAbstract This systematic review aims to comprehensively assess the epidemiology and identify risk factors associated with the severity and recurrence of hypertriglyceridemia-induced acute pancreatitis (HTG-AP). A search of PubMed, Web of Science, and Cochrane databases was conducted to identify all relevant randomized controlled trials (RCTs), prospective, or retrospective cohort studies on HTG-AP. Data related to epidemiology and risk factors for severity and recurrence of HTG-AP were extracted and analyzed. Seventy-seven studies met the inclusion criteria, comprising 1 RCT, 21 prospective studies, and 55 retrospective studies. A total of 56,617 acute pancreatitis (AP) patients were included, of which 19.99% were diagnosed with HTG-AP (n = 11,315). Compared to non-HTG-AP patients, HTG-AP patients were more likely to be male (68.7% vs. 57.3%) and younger (mean age 41.47 ± 4.32 vs. 50.25 ± 7.70 years). HTG-AP patients exhibited higher mortality rates (up to 20% vs. 15.2%), increased severity (8.3% to 100% vs. 3.8% to 47.2%), and higher recurrence rates (up to 64.8% vs. 23.3%). Analysis of temporal trends from 2002 to 2023 showed a range of HTG-AP prevalence in overall AP patients from 1.6% to 47.6%, with a slight upward trend that was not statistically significant (P = 0.1081). Regional analysis indicated relatively stable prevalence in North America (P = 0.5787), Europe (P = 0.0881), other regions (P = 0.738), while prevalence in China showed a significant increase (P = 0.0119). Thirteen studies investigated risk factors affecting HTG-AP severity, with elevated serum triglyceride (TG) levels associated with increased risk of complications such as pancreatic necrosis, systemic inflammatory response syndrome (SIRS), shock, and multi-organ failure. Additional factors including high neutrophil-to-lymphocyte ratio (NLR), elevated levels of amylase and C-reactive protein (CRP), hypocalcemia, and hypoalbuminemia were also implicated in HTG-AP severity. Smoking history, poor lipid control (TG > 3.1 mmol/L), or recurrent hypertriglyceridemia during follow-up were identified as potential predictors of HTG-AP recurrence. Our findings indicate a stable global prevalence of HTG-AP within AP patients, but a notable increase in China, possibly attributed to socio-economic and dietary factors.https://doi.org/10.1186/s12876-025-03954-4Hypertriglyceridemia-induced Acute pancreatitisIncidenceSeverityRecurrence
spellingShingle Jiongdi Lu
Zhe Wang
Wentong Mei
Kaixin Peng
Liang Zhang
Gang Wang
Kedong Xu
Zheng Wang
Yunpeng Peng
Zipeng Lu
Xiaolei Shi
Guotao Lu
Li Wen
Feng Cao
Chinese Hypertriglyceridemia-Associated Pancreatitis Study Group (CHPSG)
A systematic review of the epidemiology and risk factors for severity and recurrence of hypertriglyceridemia-induced acute pancreatitis
BMC Gastroenterology
Hypertriglyceridemia-induced Acute pancreatitis
Incidence
Severity
Recurrence
title A systematic review of the epidemiology and risk factors for severity and recurrence of hypertriglyceridemia-induced acute pancreatitis
title_full A systematic review of the epidemiology and risk factors for severity and recurrence of hypertriglyceridemia-induced acute pancreatitis
title_fullStr A systematic review of the epidemiology and risk factors for severity and recurrence of hypertriglyceridemia-induced acute pancreatitis
title_full_unstemmed A systematic review of the epidemiology and risk factors for severity and recurrence of hypertriglyceridemia-induced acute pancreatitis
title_short A systematic review of the epidemiology and risk factors for severity and recurrence of hypertriglyceridemia-induced acute pancreatitis
title_sort systematic review of the epidemiology and risk factors for severity and recurrence of hypertriglyceridemia induced acute pancreatitis
topic Hypertriglyceridemia-induced Acute pancreatitis
Incidence
Severity
Recurrence
url https://doi.org/10.1186/s12876-025-03954-4
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