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Role of pancreatic fat in the outcomes of pancreatitis.

Abstract

The role of obesity in relation to various disease processes is being increasingly studied, with reports over the last several years increasingly mentioning its association with worse outcomes in acute disease. Obesity has also gained recognition as a risk factor for severe acute pancreatitis (SAP).The mortality in SAP may be as high as 30% and is usually attributable to multi system organ failure (MSOF) earlier in the disease, and complications of necrotizing pancreatitis later [9-11]. To date there is no specific treatment for acute pancreatitis (AP) and the management is largely expectant and supportive. Obesity in general has also been associated with poor outcomes in sepsis and other pathological states including trauma and burns. With the role of unsaturated fatty acids (UFA) as propagators in SAP having recently come to light and with the recognition of acute lipotoxicity, there is now an opportunity to explore different strategies to reduce the mortality and morbidity in SAP and potentially other disease states associated with such a pathophysiology. In this review we will discuss the role of fat and implications of the consequent acute lipotoxicity on the outcomes of acute pancreatitis in lean and obese states and during acute on chronic pancreatitis.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.

    ,

    Clin-Path Associates, Tempe, AZ, USA.

    Department of Medicine, Mayo Clinic, Scottsdale, AZ, USA. Electronic address: singh.vijay@mayo.edu.

    Source

    MeSH

    Acute Disease
    Humans
    Intra-Abdominal Fat
    Multiple Organ Failure
    Obesity
    Pancreas
    Pancreatitis
    Pancreatitis, Acute Necrotizing
    Pancreatitis, Chronic
    Severity of Illness Index

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Review

    Language

    eng

    PubMed ID

    25278311

    Citation

    Acharya, Chathur, et al. "Role of Pancreatic Fat in the Outcomes of Pancreatitis." Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], vol. 14, no. 5, 2014, pp. 403-8.
    Acharya C, Navina S, Singh VP. Role of pancreatic fat in the outcomes of pancreatitis. Pancreatology. 2014;14(5):403-8.
    Acharya, C., Navina, S., & Singh, V. P. (2014). Role of pancreatic fat in the outcomes of pancreatitis. Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], 14(5), pp. 403-8. doi:10.1016/j.pan.2014.06.004.
    Acharya C, Navina S, Singh VP. Role of Pancreatic Fat in the Outcomes of Pancreatitis. Pancreatology. 2014;14(5):403-8. PubMed PMID: 25278311.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Role of pancreatic fat in the outcomes of pancreatitis. AU - Acharya,Chathur, AU - Navina,Sarah, AU - Singh,Vijay P, Y1 - 2014/07/01/ PY - 2014/04/29/received PY - 2014/06/19/revised PY - 2014/06/19/accepted PY - 2014/10/4/entrez PY - 2014/10/4/pubmed PY - 2015/6/17/medline KW - Fibrosis KW - Lipotoxicity KW - Multi system organ failure KW - Obesity KW - Outcomes KW - Pancreatitis SP - 403 EP - 8 JF - Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] JO - Pancreatology VL - 14 IS - 5 N2 - The role of obesity in relation to various disease processes is being increasingly studied, with reports over the last several years increasingly mentioning its association with worse outcomes in acute disease. Obesity has also gained recognition as a risk factor for severe acute pancreatitis (SAP).The mortality in SAP may be as high as 30% and is usually attributable to multi system organ failure (MSOF) earlier in the disease, and complications of necrotizing pancreatitis later [9-11]. To date there is no specific treatment for acute pancreatitis (AP) and the management is largely expectant and supportive. Obesity in general has also been associated with poor outcomes in sepsis and other pathological states including trauma and burns. With the role of unsaturated fatty acids (UFA) as propagators in SAP having recently come to light and with the recognition of acute lipotoxicity, there is now an opportunity to explore different strategies to reduce the mortality and morbidity in SAP and potentially other disease states associated with such a pathophysiology. In this review we will discuss the role of fat and implications of the consequent acute lipotoxicity on the outcomes of acute pancreatitis in lean and obese states and during acute on chronic pancreatitis. SN - 1424-3911 UR - https://www.unboundmedicine.com/medline/citation/25278311/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1424-3903(14)00930-2 DB - PRIME DP - Unbound Medicine ER -