Hypertriglyceridaemia-Associated Acute Pancreatitis: Risk Stratification, Drivers, and Prevention of Recurrence
Diseases, vol.14, no.2, 2026 (ESCI, Scopus)
- Publication Type: Article / Review
- Volume: 14 Issue: 2
- Publication Date: 2026
- Doi Number: 10.3390/diseases14020047
- Journal Name: Diseases
- Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, BIOSIS, Directory of Open Access Journals
- Keywords: acute pancreatitis, apolipoprotein C-III, chylomicronaemia, familial chylomicronaemia syndrome, hypertriglyceridaemia, multifactorial chylomicronaemia, recurrence prevention, triglyceride-rich lipoproteins
- Ataturk University Affiliated: No
Abstract
Hypertriglyceridaemia is the third most common aetiology of acute pancreatitis and a leading cause of recurrence in specialized lipid clinics. The risk of acute pancreatitis rises steeply once triglycerides exceed approximately 10 mmol/L (≈885 mg/dL). Still, clinically meaningful risk may occur at lower levels in the presence of chylomicronaemia, metabolic stress, or pregnancy. This mini-review synthesizes contemporary evidence on epidemiology, mechanistic links between triglyceride-rich lipoproteins and pancreatic injury, and the practical distinction between secondary (acquired) and genetic drivers of severe hypertriglyceridaemia. We summarize acute management strategies aimed at rapid triglyceride reduction (including insulin-based approaches and therapeutic plasma exchange in selected scenarios) and focus on long-term prevention of recurrence through lifestyle interventions, correction of secondary contributors, and triglyceride-lowering pharmacotherapy. Finally, we discuss emerging RNA-targeted therapies against apolipoprotein C-III and angiopoietin-like 3, which are reshaping prevention strategies for familial and persistent chylomicronaemia and may reduce pancreatitis burden in the highest-risk phenotypes.