People with metabolic dysfunction-associated steatotic liver disease (MASLD) are more likely to experience complications of acute pancreatitis if they have high serum triglyceride levels, according to study findings published in BMC Gastroenterology.

MASLD, the new name for non-alcoholic fatty liver disease (NAFLD), is responsible for a growing proportion of advanced liver disease worldwide. The accumulation of fat in the liver can lead to fibrosis, cirrhosis and even liver cancer. With no effective approved medical therapies, disease management is dependent on lifestyle changes such as weight loss and exercise.

MASLD can worsen acute pancreatitis, or inflammation of the pancreas. Elevated triglyceride levels are associated with an increased risk of both fatty liver disease and acute pancreatitis, but the interaction of all three factors is not well established.

Juan Chen, MD, of Yangzhou University in China, and colleagues sought to assess the links between serum triglyceride levels and the severity of acute pancreatitis in people with fatty liver disease. [The study authors used the older NAFLD terminology; this report follows their usage.]

Study participants with acute pancreatitis and NAFLD were split into two groups on the basis of their triglyceride levels: those with high levels and those without. The researchers included 598 people with acute pancreatitis; of these, 433 had hypertriglyceridemia, and 165 did not. The average age of the study population was 46 years, and 65% were men. Most participants had mild or moderate acute pancreatitis; a few had severe cases.

Compared to people without hypertriglyceridemia, those with high triglyceride levels had more serious acute pancreatitis. Moreover, the latter group was at a higher risk of persistent organ failure, especially persistent respiratory failure. They also had more fluid accumulation around the pancreas, known as acute peripancreatic fluid collection (APFC).

Independent risk factors for APFC included elevated serum triglycerides, recurrence of acute pancreatitis, higher body mass index and moderate or severe NAFLD. Compared to people with mild fatty liver disease, people with moderate NAFLD were twice as likely to experience APFC, while those with severe NAFLD were three times more likely.

“This study showed that triglyceride is closely related to the severity and local complications in patients with acute pancreatitis complicated with NAFLD and is an independent risk factor for the development of local complications,” wrote the researchers.

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