Relationship between low-density lipoprotein cholesterol and severe acute pancreatitis (“the lipid paradox”)

Figures & data

Figure 1 Distribution of HDL-C in 674 patients and relationship between different HDL-C levels and incidence of SAP.

Abbreviations: HDL-C, high-density lipoprotein cholesterol; SAP, severe acute pancreatitis; CI, confidence interval.

Figure 2 Distribution of LDL-C in 674 patients and relationship between different LDL-C levels and incidence of SAP.

Abbreviations: LDL-C, low-density lipoprotein cholesterol; SAP, severe acute pancreatitis; CI, confidence interval.

Figure 3 Distribution of triglyceride in 674 patients and the relationship between different triglyceride levels and incidence of SAP.

Abbreviations: SAP, severe acute pancreatitis; CI, confidence interval.

Table 1 Baseline characteristics of patients in the three study cohorts

Variable	LDL-C (mg/dL)			P-value
	<90 (n = 319)	90–150 (n = 273)	>150 (n = 82)
Age, years (IQR)	48 (37–65)	48 (38–62)	47.5 (36–57)	0.404
Male gender, n (%)	208 (65.2)	162 (59.3)	51 (62.2)	0.340
BMI, kg/m^2 (IQR)	23.5 (21.2–25.8)	23.5 (21.0–26.1)	24.2 (22.0–27.8)	0.030
Hypertension, n (%)	74 (23.0)	72 (26.4)	13 (15.9)	0.141
Diabetes mellitus, n (%)	46 (14.4)	42 (15.4)	16 (19.5)	0.523
Alcohol consumption, n (%)	42 (13.2)	37 (13.6)	13 (15.9)	0.817
Smoking, n (%)	85 (26.7)	81 (29.7)	24 (29.3)	0.698
Etiology				0.342
Biliary, n (%)	142 (44.5)	112 (41.0)	31 (37.8)
Hypertriglyceridemia, n (%)	20 (6.3)	16 (5.9)	1 (1.2)
Alcohol, n (%)	42 (13.2)	37 (13.6)	13 (15.9)
Other, n (%)	115 (36.0)	108 (40.0)	37 (45.0)
Laboratory findings
Total cholesterol (mg/dL)	146 (127–189)	199 (175–232)	267 (235–310)	<0.001
LDL-C (mg/dL)	69 (56–81)	113 (101–129)	173 (158–187)	<0.001
HDL-C (mg/dL)	38 (26–51)	41 (31–50)	41 (31–51)	0.223
Triglyceride (mg/dL)	96 (58–317)	119 (80–288)	180 (104–323)	<0.001
Hematocrit (L/L)	0.42 (0.38–0.45)	0.43 (0.38–0.46)	0.43 (0.39–0.46)	0.261
Albumin, g/L (IQR)	35 (32–39)	38 (34–40)	38 (35–41)	<0.001
ALT, U/L (IQR)	37 (18–107)	39 (20–98)	51 (22–124)	0.314
Glucose, mg/dL (IQR)	144 (114–191)	144 (119–200)	147 (121–220)	0.534
BUN, mg/dL (IQR)	14.3 (10.9–18.7)	12.3 (10.1–16.5)	12.9 (10.4–16.0)	0.004
Outcomes
SAP, n (%)	48 (15.1)	10 (3.7)	8 (9.8)
Death, n (%)	9 (2.8)	1 (0.4)	0 (0)

Notes: Data are numbers and percentages or median (25th–75th percentile), as appropriate. Cholesterol, 1 mg/dL = 0.0259 mmol/L; triglyceride, 1 mg/dL = 0.0113 mmol/L; glucose, 1 mg/dL = 0.0555 mmol/L and urea nitrogen, 1 mg/dL = 0.357 mmol/L.

Abbreviations: LDL-C, low-density lipoprotein cholesterol; n, number; IQR, interquartile range; BMI, body mass index; HDL-C, high-density lipoprotein cholesterol; ALT, alanine aminotransferase; BUN, blood urea nitrogen; SAP, severe acute pancreatitis.

Figure 4 Incidence of SAP in patients with different LDL-C levels.

Abbreviations: SAP, severe acute pancreatitis; LDL-C, low-density lipoprotein cholesterol.

Figure 5 Univariable and multivariable logistic regression plots of ORs and 95% CIs for evaluation of the relationship between HDL-C, LDL-C, triglyceride and the risk of SAP.

Abbreviations: OR, odds ratio; CI, confidence interval; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; SAP, severe acute pancreatitis.