Fatty acid analysis identifies an aberrant circulating triglyceride composition in patients with hypertriglyceridemia-induced acute pancreatitis.

Despite a correlative relationship between Hypertriglyceridemia-induced acute pancreatitis (HIAP) incidence and triglyceride (TG) levels, not all patients with very high TG levels in plasma develop HIAP, suggesting additional contributing factors. We used gas chromatography and thin layer chromatography for analysis of fatty acid (FA) composition in plasma, TGs, and red blood cells (RBC) in healthy volunteers and patients with severe hypertriglyceridemia with and without HIAP, providing a thorough understanding of recent and long-standing physiological states. We found that TGs of hypertriglyceridemic patients with current HIAP contain increased levels of oleic acid, linoleic acid, and the trans FA elaidic acid, all potentially toxic to pancreatic cells; and decreased levels of the pancreatic-protective FAs gondoic acid and docosahexaenoic acid. Moreover, we found a significant increase in relative assembly of the pro-inflammatory omega-6 PUFAs into RBC membrane phospholipids in HIAP patients. In conclusion, our data suggest a dietary FA composition characterized by higher consumption of ultra-processed foods and a metabolic milieu that increase HIAP susceptibility, and open avenues for further exploration for development of specific dietary or medical interventions to mitigate HIAP risk by altering the FA composition of plasma TGs.