Department of Gastroenterology.
Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
Eur J Gastroenterol Hepatol. 2021 Dec 1;33(12):1517-1523. doi: 10.1097/MEG.0000000000002095.
Evidence is limited concerning the association between serum concentrations of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (APO A-I) and severe acute pancreatitis (SAP). This study was designed to explore whether HDL-C and APO A-I were independently correlated to SAP after adjusting for covariates.
There were 1127 patients with acute pancreatitis who were recruited from a tertiary teaching hospital in Wenzhou from 1 January 2018 to 30 April 2020. The independent variables were baseline levels of HDL-C, and APO A-I collected within 24 h after admission. The dependent variable was the occurrence of SAP during hospitalization. Univariate and multivariate binary logistic regression were conducted to analyze the relationship between HDL-C and APO A-I and SAP. The receiver operating characteristic curve was applied to analyze the prediction power of lipid parameters and C-reactive protein for SAP.
The incidence of SAP was 11.5% among the 678 patients included in the final analysis. The serum levels of APO A-I and HDL-C were negatively related to SAP after adjusting for confounders with an odds ratio of 0.24 [95% confidence interval (CI): 0.06-0.95] and 0.16 (95% CI, 0.04-0.56), respectively. APO A-I (area under the curve = 0.69; 95% CI, 0.63-0.76) and HDL-C (area under the curve = 0.72; 95% CI, 0.66-0.79) showed higher predictive value for SAP compared with other lipid parameters.
Decreased serum concentrations of HDL-C and APO A-I are associated with SAP after adjusting for covariates.
有关高密度脂蛋白胆固醇（HDL-C）和载脂蛋白 A-I（APO A-I）血清浓度与重症急性胰腺炎（SAP）之间的关联，证据有限。本研究旨在探讨在调整协变量后，HDL-C 和 APO A-I 是否与 SAP 独立相关。
本研究共纳入了 2018 年 1 月 1 日至 2020 年 4 月 30 日期间从温州一家三级教学医院招募的 1127 名急性胰腺炎患者。自变量为入院 24 小时内采集的 HDL-C 和 APO A-I 的基线水平，因变量为住院期间 SAP 的发生情况。采用单因素和多因素二项逻辑回归分析 HDL-C 和 APO A-I 与 SAP 的关系。应用受试者工作特征曲线分析血脂参数和 C 反应蛋白对 SAP 的预测能力。
最终分析纳入的 678 例患者中 SAP 的发生率为 11.5%。在校正混杂因素后，APO A-I 和 HDL-C 的血清水平与 SAP 呈负相关，比值比分别为 0.24（95%置信区间：0.06-0.95）和 0.16（95%置信区间：0.04-0.56）。APO A-I（曲线下面积=0.69；95%置信区间：0.63-0.76）和 HDL-C（曲线下面积=0.72；95%置信区间：0.66-0.79）对 SAP 的预测价值均高于其他血脂参数。
在校正协变量后，血清 HDL-C 和 APO A-I 浓度降低与 SAP 相关。
