What to know about high triglyceride levels and pancreatitis

The pancreas has two roles in lipid (fat) metabolism. It has an exocrine function that breaks down dietary fats and an endocrine function that regulates blood sugars.

If a person has very high triglycerides (hypertriglyceridemia), their body may sometimes convert the triglycerides into substances that can trigger pancreatitis, which is inflammation of the pancreas.

Although experts do not fully understand the relationship between very high triglyceride levels and pancreatitis, they theorize that triglyceride-rich lipoproteins, which carry triglycerides and cholesterol through the bloodstream, interact with the enzyme that breaks down fats in the pancreatic capillaries.

The body then breaks down triglycerides into free fatty acids and phospholipids, which then form a lipid called lysophosphatidylcholine (LPC).

Both free fatty acids and LPC can damage the pancreas, leading to pancreatitis.

Hypertriglyceridemia is the third leading cause of acute pancreatitis and is responsible for around 5% to 25% of cases.

The higher a person’s triglyceride levels, the higher the risk of pancreatitis. Doctors consider the following hypertriglyceridemia levels when determining severity:

For those with triglyceride levels of 1000 mg/dl or higher, the incidence of acute pancreatitis increases to about 10% of cases, and those with levels of 2000 mg/dl or higher account for about 20% of pancreatitis cases.

Typically, acute pancreatitis causes severe pain and swelling in the upper abdomen, which may also reach the back.

The pain may worsen when coughing, moving vigorously, or breathing deeply. Leaning forward or sitting upright may ease the pain.

If a person has symptoms that could indicate pancreatitis, they should contact a doctor or another healthcare professional as soon as possible.

Healthcare professionals will treat acute pancreatitis due to very high triglycerides in a similar way to other causes, but they will need to lower triglyceride levels as a matter of urgency.

A person can work with their healthcare team to determine the best way to reduce their personal risk of pancreatitis. However, lifestyle adaptations can also reduce risk.

People with gallstones and those with alcohol use disorder have the highest risk of acute pancreatitis. The third most common cause is very high triglycerides.

Some people have hereditary acute pancreatitis, and research has identified specific gene alterations that predispose people to the condition.

Additionally, people with cystic fibrosis or those who have cystic fibrosis in their genes have a higher risk of both acute and chronic pancreatitis.

While pancreatitis is a serious complication of very high triglycerides, managing triglyceride levels effectively can significantly lower the risk of the condition and its recurrence.

Focusing on a healthy, balanced diet, avoiding alcohol and smoking, and taking medications as instructed by a medical professional will help an individual manage their overall health and well-being.