Association between triglyceride level and the severity of acute hypertriglyceridemic pancreatitis

Objective To investigate the association between serum triglyceride ( TG) level and the severity of acute hypertriglyceridemic pancreatitis ( AHTGP) . Methods A retrospective analysis was performed for the clinical data of 63 patients with AHTGP who were hospitalized and treated in Beijing Anzhen Hospital, Capital Medical University, from September 2015 to June 2018, and according to the new Atlanta classification criteria, these patients were divided into mild acute pancreatitis ( MAP) group with 32 patients, moderate-severe acute pancreatitis ( MSAP) group with 20 patients, and severe acute pancreatitis ( SAP) group with 11 patients. Serum TG level was recorded on admission and at 48 hours after admission. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups; the chi-square test was used for comparison of categorical data between multiple groups; the Spearman correlation analysis was used to evaluate the correlation between data; the receiver operating characteristic ( ROC) curve was used to evaluate the diagnostic efficacy of assessment indices. Results There were significant differences between the three groups in serum TG level at 48 hours after admission, Acute Physiology and Chronic Health Evaluation II ( APACHE II) score, modified CT severity index, bedside index for severity of acute pancreatitis, and Ranson score ( F = 14. 423, χ2= 44. 094, 39. 654, 30. 445, and 29. 426, all P < 0. 05) . Serum TG level on admission was only positively correlated with Ranson score ( r = 0. 491, P < 0. 001) ; serum TG level at 48 hours after admission were positively correlated with the new Atlanta classification criteria, APACHE II score, modified CT severity index, bedside index for severity of acute pancreatitis, and Ranson score ( r = 0. 396, 0. 392, 0. 400, 0. 476, and 0. 400, all P < 0. 05) . The areas under the ROC curve of serum TG level on admission and at 48 hours after admission in predicting disease severity were 0. 652 ( P = 0. 115) and 0. 895 ( P < 0. 001) , respectively, with optimal cut-off values of 34. 10 mmol/L and 6. 95 mmol/L, respectively. Conclusion Serum TG level at 48 hours after admission has a certain clinical value in predicting the severity of AHTGP.