Clinical Research

Early predictors of severity and interaction of non⁃biliary acute pancreatitis

  • Jing LI ,
  • Miao JIANG ,
  • Jingxian HU
Expand
  • Department of Gastroenterology,Jinshan Hospital,Fudan University,Shanghai 201500,China

Received date: 2023-12-28

  Online published: 2024-06-14

Abstract

Objective To explore the early prediction value of related test indicators for non-biliary acute pancreatitis and the influence of interaction of related test indicators on non-biliary acute pancreatitis. Methods A total of 280 patients with the first onset of non-biliary acute pancreatitis who were hospitalized in Jinshan Hospital of Fudan University from July 2019 to July 2023 were divided into mild group and severe group. The severe group included moderately severe and severe patients. Clinical data, tests and examination indicators of first-attack inpatients within 48 hours after admission were collected. Through logistics regression analysis, early detection indicators related to the severity of non-biliary acute pancreatitis were explored, and the influence of their interaction was studied. Results Single-factor analysis showed that albumin (ALB), thyroxine (T4), serum free triiodothyronine, albumin (ALB), Thyroxine (T4) in both groups. FT3), thyroid stimulating hormone (TSH), serum triglyceride (TG), calcium (Ca) and other indicators were statistically significant (P < 0.05); Through multi-factor logistics regression analysis, it was found that the OR values of T4, FT3, TSH, CA and other detection indicators were all less than 1 (P < 0.05); After controlling for gender, age, history of hypertension, history of diabetes and other factors, the interaction between TG and HbA1c was analyzed, the aOR was 1.500 when only HbA1c was increased (P > 0.05), the aOR was 4.488 when only TG was increased (P < 0.05), and the aOR was 5.084 when TG and HbA1c were increased simultaneously (P < 0.05). Conclusion ALB, T4, FT3, TSH, CA were protective factors of non-biliary AP, and could be used as predictive indicators of the severity of non-biliary acute pancreatitis. Interaction of HbA1c with TG increases the risk of progression to severe non-biliary acute pancreatitis.

Cite this article

Jing LI , Miao JIANG , Jingxian HU . Early predictors of severity and interaction of non⁃biliary acute pancreatitis[J]. The Journal of Practical Medicine, 2024 , 40(12) : 1701 -1705 . DOI: 10.3969/j.issn.1006-5725.2024.12.015

References

1 ROXVALL L, BENGTSON A, SENNERBY L, et al. Activation of the complement cascade by trypsin[J]. Biol Chem Hoppe Seyler, 1991, 372(4): 273-278. doi:10.1515/bchm3.1991.372.1.273
2 MEDEROS M A, REBER H A, GIRGIS M D. Acute Pancreatitis: A Review[J]. JAMA, 2021, 325(4): 382-390. doi:10.1001/jama.2020.20317
3 HU J X, ZHAO C F, WANG S L, et al. Acute pancreatitis: A review of diagnosis,severity prediction and prognosis assessment from imaging technology,scoring system and artificial intelligence[J]. 世界胃肠病学杂志:英文版, 2023, 29(37): 5268-5291.
4 FORSMARK C H E, VEGE S S, WILCOX C M. Acute Pancreatitis[J]. N Engl J Med, 2017, 376(6): 598-599. doi:10.1056/nejmc1616177
5 BANKS P A, BOLLEN T L, DERVENIS C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1): 102-111. doi:10.1136/gutjnl-2012-302779
6 BUSIREDDY K K, ALOBAIDY M, RAMALHO M, et al. Pancreatitis-imaging approach[J]. World J Gastrointest Pathophysiol, 2014, 5(3): 252-270. doi:10.4291/wjgp.v5.i3.252
7 THOENI R F. The revised Atlanta classification of acute pancreatitis: its importance for the radiologist and its effect on treatment[J]. Radiology, 2012, 262(3): 751-764. doi:10.1148/radiol.11110947
8 KISS L, FUR G, MATRAI P, et al. The effect of serum triglyceride concentration on the outcome of acute pancreatitis: systematic review and meta-analysis[J]. Sci Rep, 2018, 8(1): 14096. doi:10.1038/s41598-018-32337-x
9 VAN DEN BERG F F, DE BRUIJN, ANNA C,et al. Early laboratory biomarkers for severity in acute pancreatitis; A systematic review and meta-analysis[J]. Pancreatology, 2020, 20(7): 1302-1311. doi:10.1016/j.pan.2020.09.007
10 CHENG T, XIAO B J, LIU B F, et al. Efficiency of free thyroxine in predicting severity and mortality of patients with acute pancreatitis: A protocol for systematic review and meta-analysis[J]. Medicine (Baltimore), 2021, 100(7): e24809. doi:10.1097/md.0000000000024809
11 KUMAR B G V, PRASAD K, SINGH D, et al. Hypertriglyceridemia induced acute pancreatitis: 4 years' experience from a tertiary care institute and quick literature review[J]. J Family Med Prim Care, 2022, 11(6): 3360-3367. doi:10.4103/jfmpc.jfmpc_1426_21
12 CHOI Y H, HAN K D, CHO I R, et al. Underweight Is Associated with a Higher Risk of Acute Pancreatitis in Type 2 Diabetes: A Nationwide Cohort Study[J]. J Clin Med, 2022, 11(19):5641. doi:10.3390/jcm11195641
13 WALLER A, LONG B, KOYFMAN A, et al. Acute Pancreatitis: Updates for Emergency Clinicians[J]. J Emerg Med, 2018, 55(6): 769-779. doi:10.1016/j.jemermed.2018.08.009
14 张冰,孙秋,杜丽明,等. 前瞻性队列研究—甘油三酯葡萄糖指数与急性胰腺炎发病风险[J]. 实用医学杂志, 2023, 39(23): 3116-3119. doi:10.3969/j.issn.1006-5725.2023.23.016
15 HUANG Y, ZHU Y, PENG Y, et al. Triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio is an independent predictor of the severity of hyperlipidaemic acute pancreatitis[J]. J Hepatobiliary Pancreat Sci, 2023, 30(6): 784-791. doi:10.1002/jhbp.1281
16 KIM Y J, KIM D B, CHUNG W C, et al. Analysis of factors influencing survival in patients with severe acute pancreatitis[J]. Scand J Gastroenterol, 2017, 52(8): 904-908. doi:10.1080/00365521.2017.1310291
17 SHEN H N, CHANG Y H, CHEN H F, et al. Increased risk of severe acute pancreatitis in patients with diabetes[J]. Diabet Med, 2012, 29(11): 1419-1424. doi:10.1111/j.1464-5491.2012.03680.x
18 MA L P, LIU X, CUI B C, et al. Diabetic Ketoacidosis With Acute Pancreatitis in Patients With Type 2 Diabetes in the Emergency Department: A Retrospective Study[J]. Front Med (Lausanne), 2022, 9:813083. doi:10.3389/fmed.2022.813083
19 CHEN E X, TU YA S Q, SHE Z F, et al. The clinical characteristic of alcohol-hyperlipidemia etiologically complex type of acute pancreatitis[J]. Eur Rev Med Pharmacol Sci, 2022, 26(19): 7212-7218.
Outlines

/