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Comment & Response
May 2017

Hypertriglyceridemia and Pancreatitis—New Evidence That Less Is More

Author Affiliations
  • 1Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota
JAMA Intern Med. 2017;177(5):744-745. doi:10.1001/jamainternmed.2017.0602

To the Editor We congratulate Pederson et al1 for providing population-based data on the association between triglyceride levels and the subsequent occurrence of acute pancreatitis. Such data were unavailable before 2012, despite the 2002 National Cholesterol Education Program guideline (cited by Pederson et al) recommending treatment of triglycerides above 500 mg/dL with fibrate or nicotinic acid, which already costs several billion dollars each year in the United States.2 We are surprised, however, at their conclusions that hypertriglyceridemia at 177 mg/dL (2 mmol/L) and above is associated with high risk of acute pancreatitis and that their data may have implications in changing the standard of care in patients with hypertriglyceridemia with respect to acute pancreatitis (presumably lowering the threshold for treatment).1

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