PNLIP and alkaline phosphatase measurement: Figure 5 summarizes these findings. It shows that lipolysis during HTG-AP preferentially generates unsaturated NEFAs, which injure cells and cause organ failure as previously shown (19, 22, 23). These findings also agree with previous studies showing that unsaturation increases TG hydrolysis to NEFAs by the pancreatic lipases released in AP (23) and that HTG-AP is detrimental, irrespective of AP etiology (2, 7, 8).