Association of total cholesterol with severe acute pancreatitis: A U-shaped relationship
There is no consensus on relationship between total cholesterol levels and incidence of severe acute pancreatitis (SAP). The aim of this study was to investigate the relation between total cholesterol (TC) and the disease severity of acute pancreatitis. We conducted a cross-sectional study on patien...
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| Veröffentlicht in: | Clinical nutrition (Edinburgh, Scotland) Scotland), 2020-01, Vol.39 (1), p.250-257 |
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| creator | Hong, Wandong Zimmer, Vincent Basharat, Zarrin Zippi, Maddalena Stock, Simon Geng, Wujun Bao, Xueqin Dong, Junfeng Pan, Jingye Zhou, Mengtao |
| description | There is no consensus on relationship between total cholesterol levels and incidence of severe acute pancreatitis (SAP). The aim of this study was to investigate the relation between total cholesterol (TC) and the disease severity of acute pancreatitis.
We conducted a cross-sectional study on patients with acute pancreatitis between April 2012 and December 2015 in a university hospital. Fasting blood total cholesterol (TC) was assayed within 24 h of admission, as well as 3–5 days, 7–9 days and 13–15 days during hospitalization. Time interval before admission, age, gender, Body Mass Index, hypertension, diabetes mellitus, alcohol consumption, smoking, etiology and albumin were recorded as potential confounding factors. To assess the pattern of relationship of TC and SAP, we used restricted cubic spline analysis with multivariable logistic regression analysis. We also compared total cholesterol concentrations between patients with or without SAP at different time points.
648 patients (median age: 47.5 years; 62.4% man) were enrolled. The incidence of SAP was 10%. A U-shaped association of TC level within 24 h of admission with severity was observed in acute pancreatitis. Patients with low TC levels (240 mg/dL) had a significantly higher incidence of SAP and protracted hospital stays when compared to moderate TC levels (160–240 mg/dL). Low total cholesterol levels (OR 2.72; 95 %eCI 1.27–5.83; P = 0.01) and high total cholesterol levels (OR 2.54; 95 %eCI 1.09–5.89; P = 0.03), were still independently associated with development of SAP after adjusting for potential confounding factors. Longitudinal cohort study indicated that patients with SAP had lower total cholesterol concentrations among 3–15 days after admission compared to patients without SAP (P |
| doi_str_mv | 10.1016/j.clnu.2019.01.022 |
| format | Article |
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We conducted a cross-sectional study on patients with acute pancreatitis between April 2012 and December 2015 in a university hospital. Fasting blood total cholesterol (TC) was assayed within 24 h of admission, as well as 3–5 days, 7–9 days and 13–15 days during hospitalization. Time interval before admission, age, gender, Body Mass Index, hypertension, diabetes mellitus, alcohol consumption, smoking, etiology and albumin were recorded as potential confounding factors. To assess the pattern of relationship of TC and SAP, we used restricted cubic spline analysis with multivariable logistic regression analysis. We also compared total cholesterol concentrations between patients with or without SAP at different time points.
648 patients (median age: 47.5 years; 62.4% man) were enrolled. The incidence of SAP was 10%. A U-shaped association of TC level within 24 h of admission with severity was observed in acute pancreatitis. Patients with low TC levels (<160 mg/dL) and high TC levels (>240 mg/dL) had a significantly higher incidence of SAP and protracted hospital stays when compared to moderate TC levels (160–240 mg/dL). Low total cholesterol levels (OR 2.72; 95 %eCI 1.27–5.83; P = 0.01) and high total cholesterol levels (OR 2.54; 95 %eCI 1.09–5.89; P = 0.03), were still independently associated with development of SAP after adjusting for potential confounding factors. Longitudinal cohort study indicated that patients with SAP had lower total cholesterol concentrations among 3–15 days after admission compared to patients without SAP (P < 0.001).
Both low TC level (<160 mg/dL) and high TC (>240 mg/dL) within 24 h of admission is independently associated with an increased risk of SAP.
•A U-shaped association of cholesterol level with severity was observed in acute pancreatitis.•Patients with low total cholesterol levels less than 160 mg/dL had a high incidence of SAP.•Patients with high total cholesterol levels greater than 240 mg/dL had a high incidence of SAP.•Patients with SAP had lower total cholesterol concentrations compared to patients without SAP.</description><identifier>ISSN: 0261-5614</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2019.01.022</identifier><identifier>PMID: 30772093</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Acute pancreatitis ; Adult ; China - epidemiology ; Cholesterol - blood ; Cohort Studies ; Cross-Sectional Studies ; Female ; Humans ; Incidence ; Lipids ; Male ; Middle Aged ; Pancreatitis - blood ; Pancreatitis - epidemiology ; Risk factor ; Severe acute pancreatitis ; Severity of Illness Index ; Total cholesterol</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2020-01, Vol.39 (1), p.250-257</ispartof><rights>2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism</rights><rights>Copyright © 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-7f89f4903f22b1ed6e5f97c5c318a02a63173d1ad2305f45762e576f998dab273</citedby><cites>FETCH-LOGICAL-c356t-7f89f4903f22b1ed6e5f97c5c318a02a63173d1ad2305f45762e576f998dab273</cites><orcidid>0000-0002-6298-4717 ; 0000-0001-6857-4252</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S026156141930041X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30772093$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hong, Wandong</creatorcontrib><creatorcontrib>Zimmer, Vincent</creatorcontrib><creatorcontrib>Basharat, Zarrin</creatorcontrib><creatorcontrib>Zippi, Maddalena</creatorcontrib><creatorcontrib>Stock, Simon</creatorcontrib><creatorcontrib>Geng, Wujun</creatorcontrib><creatorcontrib>Bao, Xueqin</creatorcontrib><creatorcontrib>Dong, Junfeng</creatorcontrib><creatorcontrib>Pan, Jingye</creatorcontrib><creatorcontrib>Zhou, Mengtao</creatorcontrib><title>Association of total cholesterol with severe acute pancreatitis: A U-shaped relationship</title><title>Clinical nutrition (Edinburgh, Scotland)</title><addtitle>Clin Nutr</addtitle><description>There is no consensus on relationship between total cholesterol levels and incidence of severe acute pancreatitis (SAP). The aim of this study was to investigate the relation between total cholesterol (TC) and the disease severity of acute pancreatitis.
We conducted a cross-sectional study on patients with acute pancreatitis between April 2012 and December 2015 in a university hospital. Fasting blood total cholesterol (TC) was assayed within 24 h of admission, as well as 3–5 days, 7–9 days and 13–15 days during hospitalization. Time interval before admission, age, gender, Body Mass Index, hypertension, diabetes mellitus, alcohol consumption, smoking, etiology and albumin were recorded as potential confounding factors. To assess the pattern of relationship of TC and SAP, we used restricted cubic spline analysis with multivariable logistic regression analysis. We also compared total cholesterol concentrations between patients with or without SAP at different time points.
648 patients (median age: 47.5 years; 62.4% man) were enrolled. The incidence of SAP was 10%. A U-shaped association of TC level within 24 h of admission with severity was observed in acute pancreatitis. Patients with low TC levels (<160 mg/dL) and high TC levels (>240 mg/dL) had a significantly higher incidence of SAP and protracted hospital stays when compared to moderate TC levels (160–240 mg/dL). Low total cholesterol levels (OR 2.72; 95 %eCI 1.27–5.83; P = 0.01) and high total cholesterol levels (OR 2.54; 95 %eCI 1.09–5.89; P = 0.03), were still independently associated with development of SAP after adjusting for potential confounding factors. Longitudinal cohort study indicated that patients with SAP had lower total cholesterol concentrations among 3–15 days after admission compared to patients without SAP (P < 0.001).
Both low TC level (<160 mg/dL) and high TC (>240 mg/dL) within 24 h of admission is independently associated with an increased risk of SAP.
•A U-shaped association of cholesterol level with severity was observed in acute pancreatitis.•Patients with low total cholesterol levels less than 160 mg/dL had a high incidence of SAP.•Patients with high total cholesterol levels greater than 240 mg/dL had a high incidence of SAP.•Patients with SAP had lower total cholesterol concentrations compared to patients without SAP.</description><subject>Acute pancreatitis</subject><subject>Adult</subject><subject>China - epidemiology</subject><subject>Cholesterol - blood</subject><subject>Cohort Studies</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Lipids</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pancreatitis - blood</subject><subject>Pancreatitis - epidemiology</subject><subject>Risk factor</subject><subject>Severe acute pancreatitis</subject><subject>Severity of Illness Index</subject><subject>Total cholesterol</subject><issn>0261-5614</issn><issn>1532-1983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1PwzAQhi0EoqXwBxiQR5YEfzROgliqii-pEguV2CzXOSuu0jjYDoh_T0ILI8vd8r6P7h6ELilJKaHiZpvqpu1TRmiZEpoSxo7QlGacJbQs-DGaEiZokgk6n6CzELaEkIznxSmacJLnjJR8it4WIThtVbSuxc7g6KJqsK5dAyGCdw3-tLHGAT7AA1a6j4A71WoPQyXacIsXeJ2EWnVQYQ_NDyjUtjtHJ0Y1AS4Oe4bWD_evy6dk9fL4vFysEs0zEZPcFKWZl4QbxjYUKgGZKXOdaU4LRZgSnOa8oqpinGRmnuWCwTBMWRaV2rCcz9D1ntt5994PR8udDRqaRrXg-iAZLQaUEHyMsn1UexeCByM7b3fKf0lK5GhUbuVoVI5GJaFyMDqUrg78frOD6q_yq3AI3O0DMHz5YcHLoC20GirrQUdZOfsf_xt654eJ</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Hong, Wandong</creator><creator>Zimmer, Vincent</creator><creator>Basharat, Zarrin</creator><creator>Zippi, Maddalena</creator><creator>Stock, Simon</creator><creator>Geng, Wujun</creator><creator>Bao, Xueqin</creator><creator>Dong, Junfeng</creator><creator>Pan, Jingye</creator><creator>Zhou, Mengtao</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6298-4717</orcidid><orcidid>https://orcid.org/0000-0001-6857-4252</orcidid></search><sort><creationdate>202001</creationdate><title>Association of total cholesterol with severe acute pancreatitis: A U-shaped relationship</title><author>Hong, Wandong ; Zimmer, Vincent ; Basharat, Zarrin ; Zippi, Maddalena ; Stock, Simon ; Geng, Wujun ; Bao, Xueqin ; Dong, Junfeng ; Pan, Jingye ; Zhou, Mengtao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-7f89f4903f22b1ed6e5f97c5c318a02a63173d1ad2305f45762e576f998dab273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acute pancreatitis</topic><topic>Adult</topic><topic>China - epidemiology</topic><topic>Cholesterol - blood</topic><topic>Cohort Studies</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Lipids</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pancreatitis - blood</topic><topic>Pancreatitis - epidemiology</topic><topic>Risk factor</topic><topic>Severe acute pancreatitis</topic><topic>Severity of Illness Index</topic><topic>Total cholesterol</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hong, Wandong</creatorcontrib><creatorcontrib>Zimmer, Vincent</creatorcontrib><creatorcontrib>Basharat, Zarrin</creatorcontrib><creatorcontrib>Zippi, Maddalena</creatorcontrib><creatorcontrib>Stock, Simon</creatorcontrib><creatorcontrib>Geng, Wujun</creatorcontrib><creatorcontrib>Bao, Xueqin</creatorcontrib><creatorcontrib>Dong, Junfeng</creatorcontrib><creatorcontrib>Pan, Jingye</creatorcontrib><creatorcontrib>Zhou, Mengtao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hong, Wandong</au><au>Zimmer, Vincent</au><au>Basharat, Zarrin</au><au>Zippi, Maddalena</au><au>Stock, Simon</au><au>Geng, Wujun</au><au>Bao, Xueqin</au><au>Dong, Junfeng</au><au>Pan, Jingye</au><au>Zhou, Mengtao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of total cholesterol with severe acute pancreatitis: A U-shaped relationship</atitle><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle><addtitle>Clin Nutr</addtitle><date>2020-01</date><risdate>2020</risdate><volume>39</volume><issue>1</issue><spage>250</spage><epage>257</epage><pages>250-257</pages><issn>0261-5614</issn><eissn>1532-1983</eissn><abstract>There is no consensus on relationship between total cholesterol levels and incidence of severe acute pancreatitis (SAP). The aim of this study was to investigate the relation between total cholesterol (TC) and the disease severity of acute pancreatitis.
We conducted a cross-sectional study on patients with acute pancreatitis between April 2012 and December 2015 in a university hospital. Fasting blood total cholesterol (TC) was assayed within 24 h of admission, as well as 3–5 days, 7–9 days and 13–15 days during hospitalization. Time interval before admission, age, gender, Body Mass Index, hypertension, diabetes mellitus, alcohol consumption, smoking, etiology and albumin were recorded as potential confounding factors. To assess the pattern of relationship of TC and SAP, we used restricted cubic spline analysis with multivariable logistic regression analysis. We also compared total cholesterol concentrations between patients with or without SAP at different time points.
648 patients (median age: 47.5 years; 62.4% man) were enrolled. The incidence of SAP was 10%. A U-shaped association of TC level within 24 h of admission with severity was observed in acute pancreatitis. Patients with low TC levels (<160 mg/dL) and high TC levels (>240 mg/dL) had a significantly higher incidence of SAP and protracted hospital stays when compared to moderate TC levels (160–240 mg/dL). Low total cholesterol levels (OR 2.72; 95 %eCI 1.27–5.83; P = 0.01) and high total cholesterol levels (OR 2.54; 95 %eCI 1.09–5.89; P = 0.03), were still independently associated with development of SAP after adjusting for potential confounding factors. Longitudinal cohort study indicated that patients with SAP had lower total cholesterol concentrations among 3–15 days after admission compared to patients without SAP (P < 0.001).
Both low TC level (<160 mg/dL) and high TC (>240 mg/dL) within 24 h of admission is independently associated with an increased risk of SAP.
•A U-shaped association of cholesterol level with severity was observed in acute pancreatitis.•Patients with low total cholesterol levels less than 160 mg/dL had a high incidence of SAP.•Patients with high total cholesterol levels greater than 240 mg/dL had a high incidence of SAP.•Patients with SAP had lower total cholesterol concentrations compared to patients without SAP.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30772093</pmid><doi>10.1016/j.clnu.2019.01.022</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6298-4717</orcidid><orcidid>https://orcid.org/0000-0001-6857-4252</orcidid></addata></record> |
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| subjects | Acute pancreatitis Adult China - epidemiology Cholesterol - blood Cohort Studies Cross-Sectional Studies Female Humans Incidence Lipids Male Middle Aged Pancreatitis - blood Pancreatitis - epidemiology Risk factor Severe acute pancreatitis Severity of Illness Index Total cholesterol |
| title | Association of total cholesterol with severe acute pancreatitis: A U-shaped relationship |
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