Low Serum Ionized Calcium, Elevated High-Sensitivity C-Reactive Protein, Neutrophil-Lymphocyte Ratio, and Body Mass Index (BMI) Are Risk Factors for Severe Acute Pancreatitis in Patients with Hypertriglyceridemia Pancreatitis

Yu, Shanshan; Wu, Dong; Jin, Kui; Lu, Yin; Fu, Yangyang; Liu, Danyu; Zhang, Lili; Yu, Xuezhong; Xu, Jun

doi:10.12659/msm.915526

Cited by 28 publications

(28 citation statements)

References 29 publications

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“…Although TGs level was not associated with the severity of HTGP in this study, which is in line with the study from Yu et al [ 42 ], therapy that decrease the level of TGs less than 5.6 mmol/L is considered key to improve the outcome of HTGP. Insulin, heparin, and plasmapheresis are possible treatments to reduce serum TGs levels during the acute episode.…”

Section: Discussionsupporting

confidence: 92%

“…CRP and lipase levels upon admission were predictive for the severity of HTGP in this study. The result of the predictive role of CRP was consistent with the report from Yu and colleagues, in which 159 HTGP Chinese patients were retrospectively studied and high CRP and BMI were postulated as risk factors for severe HTGP [ 42 ]. CRP is one of the most widely utilized biomarkers in clinical practice for AP.…”

Section: Discussionsupporting

confidence: 87%

“…However, it is generally considered that the initial CRP value (at time of admission) is too early to be predictive for the severity of AP [ 45 ]. Lipase has been reported to be significantly higher in severe HTGP than in the non-severe group, although it failed to represent an independent factor for severity of HTGP [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

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The association of parameters of body composition and laboratory markers with the severity of hypertriglyceridemia-induced pancreatitis

Chen

Huang

et al. 2021

Lipids Health Dis

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Background Hypertriglyceridemia has arisen as the third leading cause of acute pancreatitis. This study aimed at exploring the association between the severity of hypertriglyceridemia-induced pancreatitis (HTGP) and computed tomography (CT)-based body composition parameters and laboratory markers. Methods Laboratory and clinical parameters were collected from 242 patients with HTGP between 2017 and 2020. Severity of HTGP was evaluated by original or modified CT severity index. Body composition parameters such as area and radiodensity of muscle, subcutaneous adipose tissue and visceral adipose tissue were calculated by CT at the level of third lumbar vertebra. Parameters were compared between mild and moderately severe to severe HTGP. Uni-variate and multi-variate Logistic regression analyses were employed to assess the risk factors of the severity of HTGP. Results Seventy patients (28.9%) presented with mild HTGP. Body mass index, waist circumference and all CT-based body composition parameters differed between male and female patients. None was associated with the severity of HTGP, neither in males nor in females. Receiver operating characteristic curves showed that areas under the curves of apolipoprotein A-I and albumin to predict the severity of HTGP were 0.786 and 0.759, respectively (all P < 0.001). Uni-variate and further multi-variate Logistic regression analysis confirmed that low serum albumin (< 35 g/L, P = 0.004, OR = 3.362, 95%CI = 1.492–8.823) and apolipoprotein A-I (< 1.1 g/L, P < 0.001, OR = 5.126, 95%CI = 2.348–11.195), as well as high C-reactive protein (> 90 mg/L, P = 0.005, OR = 3.061, 95%CI = 1.407–6.659) and lipase (P = 0.033, OR = 2.283, 95%CI = 1.070–4.873) were risk factors of moderately severe to severe HTGP. Levels of albumin, apolipoprotein A-I, C-reactive protein and lipase were also associated with the length of hospital stay (all P < 0.05). Besides, low serum albumin, low-density lipoprotein cholesterol and high radiodensity of subcutaneous adipose tissue were significant risk factors of pancreatic necrosis in patients with HTGP (all P < 0.05). Conclusions Low serum albumin and apolipoprotein A-I, and high C-reactive protein and lipase upon admission were associated with a more severe type of HTGP and longer hospital stay for these patients. Albumin and apolipoprotein A-I may serve as novel biomarkers for the severity of HTGP. However, none of the body composition parameters was associated with the severity of HTGP.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 87%

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The association of parameters of body composition and laboratory markers with the severity of hypertriglyceridemia-induced pancreatitis

Chen

Huang

et al. 2021

Lipids Health Dis

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“…CRP level upon admission was another laboratory parameter of predictive value for the severity of HTGP in our study. This nding was consistent with the study from Yu and colleagues, in which 159 HTGP Chinese patients were retrospectively enrolled and high CRP and BMI were postulated as risk factors for severe HTGP [31]. Indeed, CRP is one of the most widely utilized biomarkers in clinical practice for AP.…”

Section: Discussionsupporting

confidence: 90%

The Association of Body Composition Parameters and Laboratory Markers With The Severity of Hypertriglyceridemia-Induced Pancreatitis

Chen

Huang

et al. 2020

Preprint

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Background: Hypertriglyceridemia has arisen as the third leading cause of acute pancreatitis. This study aimed at exploring the association between the severity of hypertriglyceridemia-induced pancreatitis (HTGP) and computed tomography (CT)-based body composition parameters and laboratory markers.Methods: Clinical parameters were collected from 242 patients with HTGP between 2017 and 2020. Severity of HTGP was evaluated by original or modified CT severity index. Body composition parameters such as area and radiodensity of muscle, subcutaneous adipose tissue and visceral adipose tissue were calculated by CT at the third lumbar vertebra level. Parameters between mild and moderately severe to severe HTGP were compared. Uni-variate and multi-variate Logistic regression analyses were employed to assess the risk factors of the severity of HTGP.Results: Seventy patients with HTGP (28.9%) were mild. Body mass index, waist circumference and all CT-based body composition parameters differed between male and female patients. None was associated with the severity of HTGP, neither in the male nor in the female. Uni-variate and multi-variate Logistic regression analysis showed that low serum albumin (<35g/L) and high C-reactive protein (>90 mg/L) were risk factors of moderately severe to severe HTGP (P<0.001, OR=4.846, 95%CI=2.122-11.068; P<0.001, OR=4.230, 95%CI=2.050-8.727, respectively). Low serum albumin was also associated with pancreatic necrosis, longer hospital stay and higher scores of APACHE II, Ranson and Marshall in HTGP patients (all P<0.05).Conclusions: Low serum albumin and high C-reactive protein upon admission are associated with the severity of HTGP. However, none of the body composition parameters is associated with the severity of HTGP.

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“…Gutiérrez-Jiménez et al [160] verified a sensitivity, specificity, positive predictive value, and negative predictive value of 67%, 82%, 27%, and 96% at a maximum cut-off of 7.5 mg/dL for total calcium in predicting severe AP. Yu et al [161] showed that low serum Ca 2+ is an independent risk factor affecting the severity of AP.…”

Section: Total Calciummentioning

confidence: 99%

Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

Silva-Vaz

Abrantes

Castelo‐Branco

et al. 2020

IJMS

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Acute pancreatitis (AP) is a severe inflammation of the pancreas presented with sudden onset and severe abdominal pain with a high morbidity and mortality rate, if accompanied by severe local and systemic complications. Numerous studies have been published about the pathogenesis of AP; however, the precise mechanism behind this pathology remains unclear. Extensive research conducted over the last decades has demonstrated that the first 24 h after symptom onset are critical for the identification of patients who are at risk of developing complications or death. The identification of these subgroups of patients is crucial in order to start an aggressive approach to prevent mortality. In this sense and to avoid unnecessary overtreatment, thereby reducing the financial implications, the proper identification of mild disease is also important and necessary. A large number of multifactorial scoring systems and biochemical markers are described to predict the severity. Despite recent progress in understanding the pathophysiology of AP, more research is needed to enable a faster and more accurate prediction of severe AP. This review provides an overview of the available multifactorial scoring systems and biochemical markers for predicting severe AP with a special focus on their advantages and limitations.

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Low Serum Ionized Calcium, Elevated High-Sensitivity C-Reactive Protein, Neutrophil-Lymphocyte Ratio, and Body Mass Index (BMI) Are Risk Factors for Severe Acute Pancreatitis in Patients with Hypertriglyceridemia Pancreatitis

Cited by 28 publications

References 29 publications

The association of parameters of body composition and laboratory markers with the severity of hypertriglyceridemia-induced pancreatitis

The association of parameters of body composition and laboratory markers with the severity of hypertriglyceridemia-induced pancreatitis

The Association of Body Composition Parameters and Laboratory Markers With The Severity of Hypertriglyceridemia-Induced Pancreatitis

Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

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