The role of hypertriglyceridemia for acute kidney injury in the course of acute pancreatitis and an animal model Congye Wu a, b , Lei Zou a , Shujing Shi b , Zhihui Tong a , Xiao Shen a , Dongliang Yang a , Lu Ke a , Weiqin Li a, * , Jieshou Li a a Department of SICU, Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China b Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China article info Article history: Received 19 October 2016 Received in revised form 21 May 2017 Accepted 12 June 2017 Available online xxx Keywords: Hypertriglyceridemia Acute kidney injury Acute pancreatitis Animal model abstract Objective: The aim of this study was to investigate the role of hypertriglyceridemia for acute kidney injury (AKI) in the course of acute pancreatitis. Methods: Patients with acute pancreatitis were retrospectively divided into four groups according to admission triglyceride: normal group, mild HTG group, moderate HTG group and severe HTG group. Clinical characteristics were compared among these groups. Wild type (WT) mice and Human ApoC III transgenic (ApoCIIItg) mice were used in the next animal experiments. Severe acute pancreatitis (SAP) model was established by retrograde injection of 0.5% sodium taurocholate (0.1 ml/100 g) from duo- denum to pancreatic duct. Histological scores, serum amylase, creatinine, usea nitrogen were compared between WT mice and ApoCIIItg mice. Results: Two hundred and sixty-two patients were classified into 4 groups: normal TG (104, 39.7%), mild HTG (72, 27.5%), moderate HTG (47, 17.9%), and severe HTG (39, 14.9%) groups. The proportions of AKI were 13.5% (14/104, normal), 13.9% (10/72, mild), 21.3% (10/47, moderate), and 38.5% (15/39, severe), respectively. After establishing SAP model, the levels of serum amylase (P < 0.05) and pancreatic his- tological score (P < 0.05) of ApoCIII-SAP-9h group were significantly higher than that of WT-SAP-9h group, respectively. ApoCIII-SAP-9h group had significantly higher levels of serum creatinine (P < 0.001), usea nitrogen (P < 0.001), and kidney histological score (P < 0.05) than that of WT-SAP-9h group, respectively. Conclusions: Mild HTG has little adverse impact on disease severity of acute pancreatitis; severe HTG can aggravate kidney injury in the course of acute pancreatitis. ApoCIII-SAP mice have more serious pancreatic damage and kidney injury than WT-SAP mice. © 2017 Published by Elsevier B.V. on behalf of IAP and EPC. Introduction Hypertriglyceridemia (HTG) is an accompanying condition in acute pancreatitis (AP) accounting from 2% to 26% [1]. It has been regarded as one of the most important issues, relating to the inci- dence, disease course and recurrence of AP [2,3]. Although lots of studies focus on HTG as an etiology of AP, the relationship of HTG and disease severity is not well established. A recent systemic review indicated studies comparing the severity of hypertriglyceridemic AP with disease caused by other etiologies are heterogeneous and scarce [1]. In the study by Bala- chandra et al. [4], HTG had no significant correlation with the clinical severity of AP. Fortson et al. [5] reported that the prevalence of local complications in patients with HTG was similar to AP from other causes. However, Goyal et al. [6] found hypertriglyceridemic AP had greater severity of disease and less favorable outcomes than alcoholic pancreatitis. Elevated serum TG is independently and proportionally correlated with persistent organ failure regardless of etiology of AP [7]. Several other studies also showed that patients with HTG tended to have more severe disease course of AP [8e12]. An important reason of the heterogenicity is that few studies classify the level of serum TG more particular. Acute kidney injury (AKI) takes a proportion of 20e25% of all AP population, and the total mortality of AP patients with AKI is about 25% [13,14]. Our previous study indicated HTG is an independent * Corresponding author. Department of SICU, Research Institute of General Sur- gery, Jinling Hospital, 305, East Zhongshan Road, Nanjing, 210002, China. E-mail address: liweiqindr@vip.163.com (W. Li). Contents lists available at ScienceDirect Pancreatology journal homepage: www.elsevier.com/locate/pan http://dx.doi.org/10.1016/j.pan.2017.06.006 1424-3903/© 2017 Published by Elsevier B.V. on behalf of IAP and EPC. Pancreatology xxx (2017) 1e6 Please cite this article in press as: Wu C, et al., The role of hypertriglyceridemia for acute kidney injury in the course of acute pancreatitis and an animal model, Pancreatology (2017), http://dx.doi.org/10.1016/j.pan.2017.06.006