Nonalcoholic Fatty Liver Disease Aggravated the Severity of Acute Pancreatitis in Patients

Abstract

Background and Aim The incidence of nonalcoholic fatty liver disease (NAFLD) as a metabolic disease is increasing annually. In the present study, we aimed to explore the influence of NAFLD on the severity of acute pancreatitis (AP). Methods The severity of AP was diagnosed and analyzed according to the 2012 revised Atlanta Classification. Outcome variables, including the severity of AP, organ failure (all types of organ failure), and systemic inflammatory response syndrome (SIRS), were compared for patients with and without NAFLD. Results Six hundred and fifty-six patients were enrolled in the study and were divided into two groups according to the presence or absence of NAFLD. The non-NAFLD group contained 278 patients and the main etiology in this group was gallstone. The NAFLD group consisted of 378 patients and the main etiology was hyperlipidemia. The incidence of mild AP, moderately severe AP, and severe AP was 77.30%, 18.3%, and 4.3% in the non-NAFLD group and 58.2%, 33.9%, and 7.9% in the NAFLD group, respectively. There were significant differences between the two groups according to the severity of AP (P ≤ 0.001). In addition, the Ranson and BISAP scores as well as the incidence of SIRS and organ failure in the NAFLD group were higher than those in the non-NAFLD group (all P < 0.05). The patients were further divided into non-NAFLD, mild-NAFLD, and moderate-severe NAFLD (M+S-NAFLD) groups. The results showed that the severity of AP increased gradually from the non-NAFLD group to the M+S-NAFLD group. In addition, the incidence rates of SIRS and organ failure showed an upward trend with the aggravation of fatty liver severity. Multivariate logistic analysis showed that patients with NAFLD, especially those with M+S-NAFLD, had higher risks of SIRS and organ failure. Conclusions Compared with non-NAFLD, NAFLD has a clinically relevant impact on the severity of AP and may be an early prognostic parameter for patients with AP.

Fatty Liver Disease and Non-Alcoholic Fatty Liver Disease Worsen the Outcome in Acute Pancreatitis: A Systematic Review and Meta-Analysis

“…Based on four articles [ 18 , 19 , 32 , 42 ], the severity of FLD affects AP outcomes. All these findings imply that the severity of FLD has a negative impact on the course of AP.…”

“…An experimental study in rat AP model demonstrated that the presence of FLD increased pro-inflammatory cytokine production, which may worsen the course of the disease [ 17 ]. Cross-sectional studies confirmed that AP is often accompanied by FLD, with a prevalence between 18–43% [ 18 , 19 ].…”

Association between NAFLD and risk of prevalent chronic kidney disease: why there is a difference between east and west?

“…It is one of the most common forms of liver diseases with a global prevalence up to 30% in general population [1]. NAFLD is also a multisystem disease, affecting extra-hepatic organs such as kidneys [2,3].…”

Dysregulation of miR-192-5p in acute pancreatitis patients with nonalcoholic fatty liver and its functional role in acute pancreatitis progression

“…As a major risk factor of AP, NAFLD can contribute to the development and severity of AP through obesity, Kuppfer cell, oxidative stress and hyperlipermia [8]. The inflammatory responses have been found to be significantly enhanced by NAFLD in AP patients [25]. However, the understanding about the molecular mechanisms for the promoting effect of NAFLD on AP progression remains limited.…”