The Effect of Admission Serum Triglyceride Level on the Prediction of Severity of Acute Pancreatitis in Pregnancy

Abstract

Purpose: Previous studies indicated that the serum triglyceride level in patients with acute pancreatitis positively correlated with the severity of the disease among the general population. Despite the physiological hypertriglyceridemia in pregnant women, there are no reports on the relationship between serum triglyceride level and the severity of acute pancreatitis in pregnant (APIP) women. This study explores the relationship between serum triglyceride levels and the severity of APIP. Patients and Methods: Clinical information of APIP patients admitted to the Shengjing Affiliated Hospital of China Medical University was gathered from January 2012 to December 2020 to conduct retrospective research. The participating patients were divided into mild, moderately severe, and severe acute pancreatitis. The clinical outcomes of patients with different serum triglyceride levels (0-2.3 mmol/L, 2.23-5.65 mmol/L, 5.65-11.2 mmol/ l, ≥11.2 mmol/L) were analyzed by performing ordinal logistic regression analysis. Receiver operating curve analysis was used to calculate the threshold value of serum triglyceride concentration that can effectively predict the occurrence of severe acute pancreatitis (SAP). Results: Hypertriglyceridemic acute pancreatitis (HTG-AP) occurred in 47% of APIP patients within the group, with a high prevalence among the Han population. In the present study, the serum triglyceride concentration correlated positively with the severity of APIP (r=0.403, P < 0.05). The adjusted logistic model demonstrated that relative to nominal triglyceride levels, the OR value of SAP were 1.036 (95% CI: 0.401-2.677), ) with triglyceride at the level of 2.23-5.65 mmol/L, 5.65-11.2 mmol/l and ≥11.2 mmol/L. In APIP patients, a triglyceride concentration of 10.7mmol/L or more upon admission was a predictive value for the occurrence of SAP, with a sensitivity of 0.72 and a specificity of 0.65, AUC: 0.708 (95% CI: 0.620-0.796). Conclusion:As the serum triglyceride level upon admission increased, the frequency of local and systemic complications increased significantly.

Acute pancreatitis in pregnancy: a 10-year, multi-center, retrospective study in Beijing

“…However, the most common cause of APIP in Chinese women in this study was hypertriglyceridemia (56.3%, 18/32). The results are in line with previous studies conducted in China [ 6 , 8 ]. And, compared with the previously reported data, the proportion of APIP cases caused by hyperlipidemia was higher in our study [ 6 – 8 , 21 ].…”

“…The incidence rate of APIP in our study is 1.6/10000. The incidence of APIP in Beijing is lower than that in other regions [ 1 , 8 , 17 ]. The mean / median follow up time of MAP, MSAP and SAP patients are 8.6/8.0, 11.3/10.0 and 13.6/10.5 (Table 1 ).…”

“…In addition, most retrospective studies had a relatively long reference time-period; therefore, these studies could not characterize the changes in APIP characteristics in recent years. Furthermore, the features of APIP may vary greatly in different geographical areas and ethnic groups [ 1 , 2 , 7 , 8 ].…”

“…Of late, there have been great changes in the diagnosis and treatment of APIP. The early diagnosis, etiology and outcome of APIP have attracted the attention of many researchers [ 8 – 10 ] However, there is still a paucity of contemporary reports from China on the clinical features of APIP and the outcomes. As a relatively developed region in China, Beijing's economic development level and medical level are in the forefront of the country, and the penetration rate of medical knowledge is higher.…”

Defined, low threshold for cesarean section and multidisciplinary team management improves fetal outcome from acute pancreatitis in pregnancy

“…It has been proposed that earlier delivery may dampen maternal SIRS and improve fetal survival [11]. For this, severity prediction is required, and although severity scores have been proposed for APIP [12], including HTG levels [12,13], these have not been validated and are more complex than established AP severity predictors such as the systemic in ammatory response syndrome (SIRS) [14][15][16][17].…”