Xia Weizhi, Yu Huajun, Huang Yingbao, Yang Yunjun, Shi Liuzhi
Department of Radiology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 32000, China.
Department of Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 32000, China.
Intern Emerg Med. 2022 Mar;17(2):417-422. doi: 10.1007/s11739-021-02819-4. Epub 2021 Aug 2.
It is important to clarify the severity of acute pancreatitis (AP) in the early stages of the disease. The visceral adiposity index (VAI), calculated using the waist circumference (WC), body mass index (BMI), triglyceride (TG) levels, and high-density lipoprotein cholesterol (HDL-c), indirectly reflects visceral adiposity function and can be used to explore its value in evaluating and predicting the severity of hyperlipidaemic acute pancreatitis (HLAP). The VAIs of 227 patients with HLAP were calculated by retrospective analysis of body parameters and laboratory indicators. The correlation between the VAI and HLAP severity, local complications, and systemic inflammatory response syndrome (SIRS) response was analysed. The VAI was significantly higher in patients with severe and moderately severe AP than in patients with mild AP (both p < 0.05). Length of hospital stay (LOS), AP severity, systemic complications, Acute Physiology and Chronic Health Evaluation II (APACHE-II) score, and SIRS score were significantly correlated with the VAI in HLAP patients. The VAI had the highest area under the curve of receiver operating characteristics (ROC) (0.755, 95% confidence interval [CI], 0.691-0.819) for predicting AP severity. The multivariate-adjusted odds ratio (HR) for the VAI in the relationship of body parameters and the severity of HLAP was 3.818 (95% CI, 1.395-10.452). Our study shows that the VAI is a valuable indicator for predicting and assessing the severity of hyperlipidaemic acute pancreatitis. Its increase is closely related to poor prognosis in patients with HLAP.
在急性胰腺炎(AP)疾病早期明确其严重程度很重要。内脏脂肪指数(VAI)通过腰围(WC)、体重指数(BMI)、甘油三酯(TG)水平和高密度脂蛋白胆固醇(HDL-c)计算得出,间接反映内脏脂肪功能,可用于探讨其在评估和预测高脂血症性急性胰腺炎(HLAP)严重程度方面的价值。通过对227例HLAP患者的身体参数和实验室指标进行回顾性分析,计算其VAI。分析VAI与HLAP严重程度、局部并发症及全身炎症反应综合征(SIRS)反应之间的相关性。重度和中度重度AP患者的VAI显著高于轻度AP患者(均p < 0.05)。HLAP患者的住院时间(LOS)、AP严重程度、全身并发症、急性生理与慢性健康状况评分系统II(APACHE-II)评分及SIRS评分与VAI显著相关。VAI在预测AP严重程度方面的受试者操作特征曲线(ROC)下面积最高(0.755,95%置信区间[CI],0.691 - 0.819)。VAI在身体参数与HLAP严重程度关系中的多因素调整优势比(HR)为3.818(95% CI,1.395 - 10.452)。我们的研究表明,VAI是预测和评估高脂血症性急性胰腺炎严重程度的一个有价值指标。其升高与HLAP患者的不良预后密切相关。