Multiple Hits in Acute Pancreatitis: Components of Metabolic Syndrome Synergize Each Other’s Deteriorating Effects
IntroductionThe incidence of acute pancreatitis (AP) and the prevalence of metabolic syndrome (MetS) are growing worldwide. Several studies have confirmed that obesity (OB), hyperlipidemia (HL), or diabetes mellitus (DM) can increase severity, mortality, and complications in AP. However, there is no...
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Frontiers Media S.A.
2019-09-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphys.2019.01202/full |
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| author | Andrea Szentesi Andrea Szentesi Andrea Szentesi Andrea Párniczky Andrea Párniczky Áron Vincze Judit Bajor Szilárd Gódi Patricia Sarlós Noémi Gede Ferenc Izbéki Adrienn Halász Katalin Márta Dalma Dobszai Dalma Dobszai Imola Török Hunor Farkas Mária Papp Márta Varga József Hamvas János Novák Artautas Mickevicius Artautas Mickevicius Elena Ramirez Maldonado Ville Sallinen Dóra Illés Balázs Kui Bálint Erőss László Czakó Tamás Takács Péter Hegyi Péter Hegyi Péter Hegyi Péter Hegyi |
| author_facet | Andrea Szentesi Andrea Szentesi Andrea Szentesi Andrea Párniczky Andrea Párniczky Áron Vincze Judit Bajor Szilárd Gódi Patricia Sarlós Noémi Gede Ferenc Izbéki Adrienn Halász Katalin Márta Dalma Dobszai Dalma Dobszai Imola Török Hunor Farkas Mária Papp Márta Varga József Hamvas János Novák Artautas Mickevicius Artautas Mickevicius Elena Ramirez Maldonado Ville Sallinen Dóra Illés Balázs Kui Bálint Erőss László Czakó Tamás Takács Péter Hegyi Péter Hegyi Péter Hegyi Péter Hegyi |
| author_sort | Andrea Szentesi |
| collection | DOAJ |
| description | IntroductionThe incidence of acute pancreatitis (AP) and the prevalence of metabolic syndrome (MetS) are growing worldwide. Several studies have confirmed that obesity (OB), hyperlipidemia (HL), or diabetes mellitus (DM) can increase severity, mortality, and complications in AP. However, there is no comprehensive information on the independent or joint effect of MetS components on the outcome of AP. Our aims were (1) to understand whether the components of MetS have an independent effect on the outcome of AP and (2) to examine the joint effect of their combinations.MethodsFrom 2012 to 2017, 1435 AP cases from 28 centers were included in the prospective AP Registry. Patient groups were formed retrospectively based on the presence of OB, HL, DM, and hypertension (HT). The primary endpoints were mortality, severity, complications of AP, and length of hospital stay. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated.Results1257 patients (55.7 ± 17.0 years) were included in the analysis. The presence of OB was an independent predictive factor for renal failure [OR: 2.98 (CI: 1.33–6.66)] and obese patients spent a longer time in hospital compared to non-obese patients (12.1 vs. 10.4 days, p = 0.008). HT increased the risk of severe AP [OR: 3.41 (CI: 1.39–8.37)], renal failure [OR: 7.46 (CI: 1.61–34.49)], and the length of hospitalization (11.8 vs. 10.5 days, p = 0.020). HL increased the risk of local complications [OR: 1.51 (CI: 1.10–2.07)], renal failure [OR: 6.4 (CI: 1.93–21.17)], and the incidence of newly diagnosed DM [OR: 2.55 (CI: 1.26–5.19)]. No relation was found between the presence of DM and the outcome of AP. 906 cases (mean age ± SD: 56.9 ± 16.7 years) had data on all four components of MetS available. The presence of two, three, or four MetS factors increased the incidence of an unfavorable outcome compared to patients with no MetS factors.ConclusionOB, HT, and HL are independent risk factors for a number of complications. HT is an independent risk factor for severity as well. Components of MetS strongly synergize each other’s detrimental effect. It is important to search for and follow up on the components of MetS in AP. |
| first_indexed | 2024-04-12T10:26:27Z |
| format | Article |
| id | doaj.art-da721895059a41fc878ab041e8cc5853 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-04-12T10:26:27Z |
| publishDate | 2019-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Physiology |
| spelling | doaj.art-da721895059a41fc878ab041e8cc58532022-12-22T03:36:58ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2019-09-011010.3389/fphys.2019.01202470163Multiple Hits in Acute Pancreatitis: Components of Metabolic Syndrome Synergize Each Other’s Deteriorating EffectsAndrea Szentesi0Andrea Szentesi1Andrea Szentesi2Andrea Párniczky3Andrea Párniczky4Áron Vincze5Judit Bajor6Szilárd Gódi7Patricia Sarlós8Noémi Gede9Ferenc Izbéki10Adrienn Halász11Katalin Márta12Dalma Dobszai13Dalma Dobszai14Imola Török15Hunor Farkas16Mária Papp17Márta Varga18József Hamvas19János Novák20Artautas Mickevicius21Artautas Mickevicius22Elena Ramirez Maldonado23Ville Sallinen24Dóra Illés25Balázs Kui26Bálint Erőss27László Czakó28Tamás Takács29Péter Hegyi30Péter Hegyi31Péter Hegyi32Péter Hegyi33Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, HungaryFirst Department of Medicine, University of Szeged, Szeged, HungaryDoctoral School of Clinical Medicine, University of Szeged, Szeged, HungaryInstitute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, HungaryHeim Pál National Institute of Pediatrics, Budapest, HungaryDivision of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, HungaryDivision of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, HungaryDivision of Translational Medicine, First Department of Medicine, Medical School, University of Pécs, Pécs, HungaryDivision of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, HungaryInstitute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, HungarySzent György Teaching Hospital of Fejér County, Székesfehérvár, HungarySzent György Teaching Hospital of Fejér County, Székesfehérvár, HungaryInstitute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, HungaryInstitute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, HungaryDoctoral School of Clinical Medicine, University of Szeged, Szeged, HungaryCounty Emergency Clinical Hospital – Gastroenterology and University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureş, RomaniaCounty Emergency Clinical Hospital – Gastroenterology and University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureş, RomaniaDivision of Gastroenterology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary0Dr. Réthy Pál Hospital of Békés County, Békéscsaba, Hungary1Bajcsy-Zsilinszky Hospital, Budapest, Hungary2Department of Gastroenterology, Pándy Kálmán Hospital of Békés County, Gyula, Hungary3Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania4Clinics of Abdominal Surgery, Nephrourology and Gastroenterology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania5Consorci Sanitari del Garraf, Sant Pere de Ribes, Barcelona, Spain6Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, FinlandFirst Department of Medicine, University of Szeged, Szeged, HungaryFirst Department of Medicine, University of Szeged, Szeged, HungaryInstitute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, HungaryFirst Department of Medicine, University of Szeged, Szeged, HungaryFirst Department of Medicine, University of Szeged, Szeged, HungaryInstitute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, HungaryFirst Department of Medicine, University of Szeged, Szeged, HungaryDivision of Translational Medicine, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary7Hungarian Academy of Sciences – University of Szeged, Momentum Gastroenterology Multidisciplinary Research Group, Szeged, HungaryIntroductionThe incidence of acute pancreatitis (AP) and the prevalence of metabolic syndrome (MetS) are growing worldwide. Several studies have confirmed that obesity (OB), hyperlipidemia (HL), or diabetes mellitus (DM) can increase severity, mortality, and complications in AP. However, there is no comprehensive information on the independent or joint effect of MetS components on the outcome of AP. Our aims were (1) to understand whether the components of MetS have an independent effect on the outcome of AP and (2) to examine the joint effect of their combinations.MethodsFrom 2012 to 2017, 1435 AP cases from 28 centers were included in the prospective AP Registry. Patient groups were formed retrospectively based on the presence of OB, HL, DM, and hypertension (HT). The primary endpoints were mortality, severity, complications of AP, and length of hospital stay. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated.Results1257 patients (55.7 ± 17.0 years) were included in the analysis. The presence of OB was an independent predictive factor for renal failure [OR: 2.98 (CI: 1.33–6.66)] and obese patients spent a longer time in hospital compared to non-obese patients (12.1 vs. 10.4 days, p = 0.008). HT increased the risk of severe AP [OR: 3.41 (CI: 1.39–8.37)], renal failure [OR: 7.46 (CI: 1.61–34.49)], and the length of hospitalization (11.8 vs. 10.5 days, p = 0.020). HL increased the risk of local complications [OR: 1.51 (CI: 1.10–2.07)], renal failure [OR: 6.4 (CI: 1.93–21.17)], and the incidence of newly diagnosed DM [OR: 2.55 (CI: 1.26–5.19)]. No relation was found between the presence of DM and the outcome of AP. 906 cases (mean age ± SD: 56.9 ± 16.7 years) had data on all four components of MetS available. The presence of two, three, or four MetS factors increased the incidence of an unfavorable outcome compared to patients with no MetS factors.ConclusionOB, HT, and HL are independent risk factors for a number of complications. HT is an independent risk factor for severity as well. Components of MetS strongly synergize each other’s detrimental effect. It is important to search for and follow up on the components of MetS in AP.https://www.frontiersin.org/article/10.3389/fphys.2019.01202/fullacute pancreatitismetabolic syndromeobesitydiabetes mellitushypertensionhyperlipidemia |
| spellingShingle | Andrea Szentesi Andrea Szentesi Andrea Szentesi Andrea Párniczky Andrea Párniczky Áron Vincze Judit Bajor Szilárd Gódi Patricia Sarlós Noémi Gede Ferenc Izbéki Adrienn Halász Katalin Márta Dalma Dobszai Dalma Dobszai Imola Török Hunor Farkas Mária Papp Márta Varga József Hamvas János Novák Artautas Mickevicius Artautas Mickevicius Elena Ramirez Maldonado Ville Sallinen Dóra Illés Balázs Kui Bálint Erőss László Czakó Tamás Takács Péter Hegyi Péter Hegyi Péter Hegyi Péter Hegyi Multiple Hits in Acute Pancreatitis: Components of Metabolic Syndrome Synergize Each Other’s Deteriorating Effects Frontiers in Physiology acute pancreatitis metabolic syndrome obesity diabetes mellitus hypertension hyperlipidemia |
| title | Multiple Hits in Acute Pancreatitis: Components of Metabolic Syndrome Synergize Each Other’s Deteriorating Effects |
| title_full | Multiple Hits in Acute Pancreatitis: Components of Metabolic Syndrome Synergize Each Other’s Deteriorating Effects |
| title_fullStr | Multiple Hits in Acute Pancreatitis: Components of Metabolic Syndrome Synergize Each Other’s Deteriorating Effects |
| title_full_unstemmed | Multiple Hits in Acute Pancreatitis: Components of Metabolic Syndrome Synergize Each Other’s Deteriorating Effects |
| title_short | Multiple Hits in Acute Pancreatitis: Components of Metabolic Syndrome Synergize Each Other’s Deteriorating Effects |
| title_sort | multiple hits in acute pancreatitis components of metabolic syndrome synergize each other s deteriorating effects |
| topic | acute pancreatitis metabolic syndrome obesity diabetes mellitus hypertension hyperlipidemia |
| url | https://www.frontiersin.org/article/10.3389/fphys.2019.01202/full |
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