Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China.
J Hepatobiliary Pancreat Sci. 2023 Jun;30(6):784-791. doi: 10.1002/jhbp.1281. Epub 2022 Dec 1.
The incidence of acute pancreatitis caused by hyperlipidaemia is increasing. A quick and easy diagnosis of the severity of hyperlipidaemic acute pancreatitis (HTGP) is important to improve patient prognosis and reduce mortality. Previous studies reported that insulin resistance (IR) is associated with acute pancreatitis. Our study aimed to investigate the correlation between the triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio and HTGP.
Patients' laboratory and clinical parameters were obtained from the institutional pancreatitis database. Univariate and multivariate logistic regression analyses were applied to evaluate the risk factors for the severity of HTGP and the efficacy of four clinical scoring systems: Ranson's Criteria, Acute Physiology and Chronic Health Evaluation II (APACHE II), the Bedside Index for Severity in Acute Pancreatitis (BISAP), and Marshall.
Of 290 patients, 134 (46.2%) were diagnosed with moderately severe to severe HTGP. The TG/HDL-C ratio was higher in the moderately severe to severe HTGP subgroup than in the mild HTGP subgroup. Among the independent risk factors, such as amylase, albumin, aspartate transaminase (AST), systemic inflammatory response syndrome (SIRS), and TG/HDL-C ratio, the TG/HDL-C ratio had the highest area under the curve (AUC) (0.727, 95% CI, 0.571-0.701). In comparison with other clinical scoring systems, the TG/HDL-C ratio has a relatively preferable predictive ability.
Our findings suggest that the TG/HDL-C ratio is positively correlated with HTGP severity and could be used as a simple indicator of severe HTGP.
由高脂血症引起的急性胰腺炎的发病率正在增加。快速、简便地诊断高脂血症性急性胰腺炎（HTGP）的严重程度对于改善患者预后和降低死亡率非常重要。先前的研究表明，胰岛素抵抗（IR）与急性胰腺炎有关。我们的研究旨在探讨甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）比值与 HTGP 的相关性。
从机构胰腺炎数据库中获取患者的实验室和临床参数。应用单因素和多因素逻辑回归分析评估 HTGP 严重程度的危险因素和四种临床评分系统的疗效：Ranson 标准、急性生理学和慢性健康评估 II（APACHE II）、床边严重程度急性胰腺炎评分（BISAP）和马歇尔。
在 290 名患者中，134 名（46.2%）被诊断为中度至重度 HTGP。中度至重度 HTGP 亚组的 TG/HDL-C 比值高于轻度 HTGP 亚组。在独立危险因素中，如淀粉酶、白蛋白、天门冬氨酸转氨酶（AST）、全身炎症反应综合征（SIRS）和 TG/HDL-C 比值中，TG/HDL-C 比值的曲线下面积（AUC）最高（0.727，95%CI，0.571-0.701）。与其他临床评分系统相比，TG/HDL-C 比值具有相对较好的预测能力。
我们的研究结果表明，TG/HDL-C 比值与 HTGP 的严重程度呈正相关，可以作为严重 HTGP 的简单指标。
