Value of triglyceride glucose-body mass index in evaluating the severity of hyperlipidemic acute pancreatitis

Pingping LUO; Qun LIU; Liwen HUANG

doi:10.12449/JCH240824

Volume 40 Issue 8

Aug. 2024

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Article Navigation > Journal of Clinical Hepatology > 2024 > 40(8): 1661-1665

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Value of triglyceride glucose-body mass index in evaluating the severity of hyperlipidemic acute pancreatitis

DOI: 10.12449/JCH240824

Pingping LUO^a,
Qun LIU^{a
,
,
,},
Liwen HUANG^b

a.
Department of Gastroenterology，Tianyou Hospital Affiliated to Wuhan University of Science and Technology，Wuhan 430064，China
b.
Department of Infectious Diseases，Tianyou Hospital Affiliated to Wuhan University of Science and Technology，Wuhan 430064，China

Research funding:

Scientific Research Project of Hubei Provincial Health Commission (WJ2019M257)

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Corresponding author: LIU Qun， 1926247724@qq.com （ORCID： 0009-0000-4261-0120）
Received Date: 2023-12-06
Accepted Date: 2024-02-01
Published Date: 2024-08-25

Abstract

Abstract

Objective To investigate the value of triglyceride glucose-body mass index （TyG-BMI） index in predicting the severity of hyperlipidemic acute pancreatitis （HLAP）. Methods A retrospective analysis was performed for the clinical data of 185 patients with HLAP who were admitted to Tianyou Hospital Affiliated to Wuhan University of Science and Technology from January 2021 to December 2023， and according to the revised Atlanta classification criteria for acute pancreatitis， they were divided into mild group with 95 patients and moderate or severe group with 90 patients. Clinical features were compared between the two groups to analyze the correlation between TyG-BMI and the severity of HLAP， and the efficacy of TyG-BMI in predicting the severity of HLAP was analyzed. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate Logistic regression analyses were used to investigate the influencing factors for the severity of HLAP. A Spearman correlation analysis was used to investigate the correlation between TyG-BMI and the severity of HLAP， and the receiver operating characteristic （ROC） curve was used to analyze the efficacy of TyG-BMI in predicting the severity of HLAP. Results There were significant differences between the mild group and the moderate or severe group in creatinine， blood glucose （GLU）， triglyceride， TyG-BMI， and Bedside Index for Severity in Acute Pancreatitis （BISAP） score （Z=-2.059，-7.217，-7.799，-9.566 and-11.386，all P<0.05）. The multivariate Logistic regression analysis showed that BISAP score （odds ratio ［OR］=4.221， 95% confidence interval ［CI］： 1.421‍ ‍—‍ ‍12.538， P=0.001）， TyG-BMI （OR=1.262， 95%CI： 1.140‍ ‍—‍ ‍1.396， P=0.010）， and GLU （OR=1.316， 95%CI： 1.040‍ ‍—‍ ‍1.666， P=0.022） were independent risk factors for the severity of HLAP and were positively correlated with the severity of HLAP （r=0.839， 0.705， and 0.532， all P<0.05）. In the comparison of the efficacy of these indicators in predicting the severity of HLAP， TyG-BMI had a slightly lower efficacy than BISAP score （Z=-4.368， P<0.001） and a significantly better efficacy than GLU （Z=2.155， P<0.001）， with an area under the ROC curve of 0.891， a sensitivity of 91.10%， and a specificity of 96.80%. Conclusion TyG-BMI index has a certain value in predicting the severity of HLAP and can be used in clinical comprehensive assessment of HLAP.
- Pancreatitis,
- Hyperlipidemias,
- Triglyceride Glucose-Body Mass Index

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据估计，长期暴露于甲氨蝶呤(MTX)导致严重肝纤维化的风险约为5%，这促使人们采取强化监测策略。然而，现有证据来源于回顾性研究，这些研究低估了肝病的风险因素。在Atallah等一项纵向队列研究中，使用两种非侵入性标志物评估了长期MTX治疗对肝纤维化的风险。

在2014年—2021年，笔者从6个英国研究中心前瞻性招募了诊断为≥2年类风湿关节炎或银屑病的成年患者。MTX组包括接受MTX治疗≥6个月的患者，而未暴露组包括从未接受MTX的患者。所有的患者都进行了完整的肝脏分析，包括瞬时弹性成像(TE)和增强肝纤维化(ELF)标志物测量。

共纳入999例患者，平均(60.8±12)岁，女性占62.3%。在976例有效TE值中，149例(15.3%)患者肝硬度≥7.9 kPa。在892例有效ELF值中，262例(29.4%)患者ELF≥9.8。年龄和BMI与肝硬度升高和肝纤维化独立相关。MTX累积剂量和持续时间都与肝硬度升高无关。糖尿病是与肝硬度≥7.9 kPa相关性最显著的危险因素(校正比值比=3.19，95%可信区间：1.95~5.20，P＜0.001)。定期使用非甾体类抗炎药与ELF≥9.8的相关性最强(优势比=1.76，95%可信区间：1.20~2.56，P=0.003)，表明类风湿性关节炎的关节炎症程度可能与作为肝纤维化的非侵入性标志物的ELF相混淆。

笔者认为，先前可能高估了MTX本身导致的肝纤维化风险，有必要考虑修改MTX目前的监测准则。

摘译自ATALLAH E, GROVE JI, CROOKS C, et al. Risk of liver fibrosis associated with long-term methotrexate therapy may be overestimated[J]. J Hepatol, 2023. DOI: 10.1016/j.jhep.2022.12.034. [Oline ahead of print]

(吉林大学第一医院肝胆胰内科纪竹慧辛桂杰报道)

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Value of triglyceride glucose-body mass index in evaluating the severity of hyperlipidemic acute pancreatitis

DOI: 10.12449/JCH240824

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Value of triglyceride glucose-body mass index in evaluating the severity of hyperlipidemic acute pancreatitis

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