PhD Scientific Days 2026

Theoretical and Translational Medicine 3.

The role of cholesterol in the progression of pancreatic disease: a post hoc analysis of longitudinal prospective data

Name of the presenter

Lipp, Mónika Bernadett

Institute/workplace of the presenter

Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary

Authors

Mónika Lipp^1,2, Andrea Szentesi^2,3, Zsolt Abonyi-Tóth², Nelli Farkas³, Vivien Vass³, Katalin Márta^1,2,3, Ferenc Izbéki⁴, László Gajdán⁴, Bálint Erőss^1,2,3, Péter Hegyi^1,2,3,5, Alexandra Mikó^3,6,7, the Hungarian Pancreatic Study Group⁸
1: Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
2: Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
3: Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
4: Szent György Teaching Hospital of Fejér County, Székesfehérvár, Hungary
5: Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation, University of Szeged, Szeged, Hungary
6: Centre for Translational Medicine, Semmelweis University, Budapest, Hungar
7: Department of Medical Genetics, Medical School, University of Pécs, Pécs, Hungary
8: HPSG

Text of the abstract

Introduction
Acute pancreatitis (AP) carries a 5.5% one-year mortality, highlighting the need for long-term follow-up. Hypercholesterolemia (HCH) has been linked to adverse outcomes.
Aims
Our study aimed to evaluate the impact of cholesterol levels on pancreatic disease progression during the acute phase and in a prospective multicentre follow-up in the late phase of the disease.
Methods
Data from 562 AP patients (GOULASH-study) and 242 patients from follow-up (GOULASH-PLUS study) were analyzed. Acute-phase outcomes included disease severity, local complications, organ failure, necrosis, length of hospital stay, and mortality. The follow-up assessed long-term morphological progression and endocrine pancreatic damage over four years. Associations between HCH (total cholesterol) and disease progression were evaluated using multivariate regression models.
Result
Among AP patients, 303 had mild, 220 moderate, and 39 severe disease. Patients with organ failure (n=67) had a higher mean cholesterol than those without organ failure (n=495) (6.28±4.92 vs 4.91±2.55 mmol/L; p=0.019). During follow-up, nearly half of HCH patients progressed to recurrent AP, early chronic pancreatitis, or chronic pancreatitis by year 3, compared with 30% of patients with normal cholesterol. HCH more than doubled the odds of disease progression (OR 2.21, 95% CI 1.01–4.85; p = 0.047) and independently increased the risk of glycemic deterioration (OR 3.43, 95% CI 1.04–12.5; p = 0.050), with fewer HCH patients remaining normoglycemic (30% vs. 44%).
Conclusion
Hypercholesterolemia is associated with an increased risk of developing complications during the acute and late phases, supporting the importance of early identification and management in AP patients.
Funding
SE250 scholarship, Semmelweis University Research, Development and Innovation Fund