Xinyu Xu, Jiang Zhou, Qing Ai, Lihua Li, Xiehong Liu, Lin Zhou
College of Clinical Laboratory, Changsha Medical University, Changsha, Hunan, China.
Changsha Shanshui Medical Laboratory Co., Ltd, Changsha, Hunan, China.
Sci Rep. 2025 Jan 23;15(1):2924. doi: 10.1038/s41598-025-86664-x.
To evaluate the clinical utility of PCT, CRP, IL-6, NLR, and TyG index in improving the early diagnosis and severity assessment of acute pancreatitis (AP). This retrospective study included 137 AP patients and 30 healthy controls from Hunan Provincial People's Hospital (January 2021-September 2023). Univariate and multivariate logistic regression analyses assessed the associations between biomarkers and severe acute pancreatitis (SAP). Receiver operating characteristic (ROC) curves, DeLong test, and Bonferroni correction were used to evaluate predictive performance. Model robustness was validated via 5-fold cross-validation. PCT, CRP, IL-6, NLR, and TyG index levels were significantly elevated in AP patients compared to controls (P < 0.001) and correlated with disease severity (P < 0.05). CRP and NLR levels differed significantly among mild, moderate, and severe AP (P < 0.01). Alcohol consumption and hyperlipidemia were significantly linked to AP severity (P for trend < 0.0001). Multivariate analysis identified hyperlipidemia (OR = 3.030, P = 0.040), CRP (OR = 1.011, P < 0.001), and NLR (OR = 1.078, P = 0.020) as independent SAP predictors. The combined model of CRP + NLR + TyG achieved the highest AUC (0.882, sensitivity = 77.2%, specificity = 88.5%), though it was not significantly better than CRP + NLR or CRP + TyG models (P > 0.05). 5-fold cross-validation confirmed consistent performance (mean AUC = 0.817 ± 0.118). PCT, CRP, IL-6, NLR, and TyG index are valuable in diagnosing and assessing AP prognosis. Hyperlipidemia, CRP, and NLR are reliable independent predictors of SAP. Combining multiple biomarkers enhances diagnostic precision and provides guidance for personalized treatment strategies in AP.
评估降钙素原（PCT）、C反应蛋白（CRP）、白细胞介素-6（IL-6）、中性粒细胞与淋巴细胞比值（NLR）以及甘油三酯葡萄糖指数（TyG指数）在改善急性胰腺炎（AP）早期诊断及严重程度评估中的临床应用价值。这项回顾性研究纳入了湖南省人民医院137例AP患者及30例健康对照（2021年1月至2023年9月）。单因素及多因素逻辑回归分析评估了生物标志物与重症急性胰腺炎（SAP）之间的关联。采用受试者工作特征（ROC）曲线、德龙检验及邦费罗尼校正来评估预测性能。通过五折交叉验证来验证模型稳健性。与对照组相比，AP患者的PCT、CRP、IL-6、NLR及TyG指数水平显著升高（P < 0.001），且与疾病严重程度相关（P < 0.05）。轻度、中度及重度AP患者的CRP及NLR水平差异显著（P < 0.01）。饮酒及高脂血症与AP严重程度显著相关（趋势P < 0.0001）。多因素分析确定高脂血症（比值比[OR] = 3.030，P = 0.040）、CRP（OR = 1.011，P < 0.001）及NLR（OR = 1.078，P = 0.020）为独立的SAP预测因素。CRP + NLR + TyG联合模型的曲线下面积（AUC）最高（0.882，灵敏度 = 77.2%，特异度 = 88.5%），但并不显著优于CRP + NLR或CRP + TyG模型（P > 0.05）。五折交叉验证证实性能一致（平均AUC = 0.817 ± 0.118）。PCT、CRP、IL-6、NLR及TyG指数在诊断及评估AP预后方面具有重要价值。高脂血症、CRP及NLR是SAP可靠的独立预测因素。联合多种生物标志物可提高诊断准确性，并为AP的个性化治疗策略提供指导。
