Recurrent Hypertriglyceridemic Acute Pancreatitis: Risk Stratification, Metabolic Susceptibility, and Secondary Prevention

Authors

  • Fanyl Kong, MD Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China Author https://orcid.org/0000-0003-4670-9624
  • Jaining Li MD Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China ; Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, United States Author
  • Yanbin Dong MD Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China Author
  • Yuan Li, MD Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China Author
  • Dong Wu MD Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China ; Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China Author

DOI:

https://doi.org/10.69734/b2mjdg03

Keywords:

Acute Pancreatitis, Hypertriglyceridemia, SMART approach, secondary prevention, Chylomicronemia, Recurrence

Abstract

Hypertriglyceridemia-associated acute pancreatitis (HTG-AP) is increasingly encountered, particularly among patients with metabolic comorbidities. Management extends beyond triglyceride (TG) lowering during the acute episode: clinicians must confirm etiologic attribution, address reversible drivers, assess individual susceptibility, and initiate a sustainable prevention plan before discharge. Recurrence reflects longitudinal TG burden, metabolic and genetic susceptibility, other pancreatic risk factors, and gaps in follow-up. Unlike acute TG-lowering strategies, which focus on the index hospitalization, secondary prevention requires longitudinal assessment of metabolic exposure, individual susceptibility, and treatment durability. Here we describe our SMART approach, which organizes these tasks as Screen and confirm, Modify triggers, Assess susceptibility, Reduce TG burden, and Track and tailor long-term management.

Author Biography

  • Dong Wu MD, Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China ; Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
    Vice President of Peking Union Medical College Hospital Chief Physician of Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Shuaifuyuan, No.1, Dongcheng District, Beijing, China,100730

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Published

2026-09-22

Issue

Vol. 3 No. 3 (2026): SMART-MD Journal of Precision Medicine Vol 3, No 3, (Summer) 2026

Section

SMART Approach

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Copyright (c) 2026 SMART-MD Journal of Precision Medicine

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How to Cite

Kong, F., Li, J., Dong, Y., Li, Y., & Wu, D. (2026). Recurrent Hypertriglyceridemic Acute Pancreatitis: Risk Stratification, Metabolic Susceptibility, and Secondary Prevention. SMART-MD Journal of Precision Medicine, 3(3), e257 - 2264. https://doi.org/10.69734/b2mjdg03