High hsCRP concentration is associated with acute pancreatitis in multifactorial chylomicronemia syndrome.

Fructose intake High-sensitivity C-reactive protein Low-grade inflammation Multifactorial chylomicronemia syndrome Pancreatitis

Journal

The Journal of clinical endocrinology and metabolism
ISSN: 1945-7197
Titre abrégé: J Clin Endocrinol Metab
Pays: United States
ID NLM: 0375362

Informations de publication

Date de publication:
27 Feb 2024
Historique:
received: 13 11 2023
revised: 01 02 2024
accepted: 23 02 2024
medline: 27 2 2024
pubmed: 27 2 2024
entrez: 27 2 2024
Statut: aheadofprint

Résumé

Multifactorial chylomicronemia syndrome (MCS) is a severe form of hypertriglyceridemia (hyperTG) associated with an increased risk of acute pancreatitis (AP). However, the risk of AP is very heterogenous in MCS. Previous studies suggested that inflammation might promote disease progression in hyperTG-induced AP. To determine if low-grade inflammation is associated with AP in MCS. This study included 102 subjects with MCS for which high-sensitivity C-reactive protein (hsCRP) concentration was measured at their first visit at the Montreal Clinical Research Institute. MCS subjects with a previous history of AP had a significant higher hsCRP concentration (4.62 mg/L vs. 2.61 mg/L; p=0.003) and high hsCRP concentration (≥3mg/L) was independently associated with AP prevalence (p<0.05). Up to 64% of the variability in AP prevalence was explained by the maximal TG concentration, hsCRP concentration, the presence of rare variants in TG-related genes, and fructose intake based on a stepwise multivariate regression model (p<0.0001). This retrospective study showed for the first time that hsCRP concentration is strongly associated with AP prevalence in MCS. It also suggests that low-grade inflammation may be a driver of AP in severe hypertriglyceridemia. Prospective studies could help determine the causality of this association and assess whether medication known to reduce low-grade inflammation could help prevent AP in individuals with severe hypertriglyceridemia.

Sections du résumé

BACKGROUND BACKGROUND
Multifactorial chylomicronemia syndrome (MCS) is a severe form of hypertriglyceridemia (hyperTG) associated with an increased risk of acute pancreatitis (AP). However, the risk of AP is very heterogenous in MCS. Previous studies suggested that inflammation might promote disease progression in hyperTG-induced AP.
OBJECTIVE OBJECTIVE
To determine if low-grade inflammation is associated with AP in MCS.
METHODS METHODS
This study included 102 subjects with MCS for which high-sensitivity C-reactive protein (hsCRP) concentration was measured at their first visit at the Montreal Clinical Research Institute.
RESULTS RESULTS
MCS subjects with a previous history of AP had a significant higher hsCRP concentration (4.62 mg/L vs. 2.61 mg/L; p=0.003) and high hsCRP concentration (≥3mg/L) was independently associated with AP prevalence (p<0.05). Up to 64% of the variability in AP prevalence was explained by the maximal TG concentration, hsCRP concentration, the presence of rare variants in TG-related genes, and fructose intake based on a stepwise multivariate regression model (p<0.0001).
CONCLUSION CONCLUSIONS
This retrospective study showed for the first time that hsCRP concentration is strongly associated with AP prevalence in MCS. It also suggests that low-grade inflammation may be a driver of AP in severe hypertriglyceridemia. Prospective studies could help determine the causality of this association and assess whether medication known to reduce low-grade inflammation could help prevent AP in individuals with severe hypertriglyceridemia.

Identifiants

pubmed: 38412316
pii: 7614750
doi: 10.1210/clinem/dgae103
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Simon-Pierre Guay (SP)

Genetic Dyslipidemias Clinic of the Montreal Clinical Research Institute, Montréal, Québec, Canada.
Department of Medicine, Division of Endocrinology, Université de Montréal, Montréal, Québec, Canada.

Martine Paquette (M)

Genetic Dyslipidemias Clinic of the Montreal Clinical Research Institute, Montréal, Québec, Canada.

Chantal Blais (C)

Genetic Dyslipidemias Clinic of the Montreal Clinical Research Institute, Montréal, Québec, Canada.

Andréanne Fortin (A)

Genetic Dyslipidemias Clinic of the Montreal Clinical Research Institute, Montréal, Québec, Canada.

Sophie Bernard (S)

Genetic Dyslipidemias Clinic of the Montreal Clinical Research Institute, Montréal, Québec, Canada.

Alexis Baass (A)

Genetic Dyslipidemias Clinic of the Montreal Clinical Research Institute, Montréal, Québec, Canada.
Department of Medecine, Divisions of Experimental Medicine and Medical Biochemistry, McGill University, Montréal, Québec, Canada.

Classifications MeSH