Association of nonalcoholic fatty liver disease with the severity of hyperlipidemic acute pancreatitis

Pei MEI; Zhengle ZHANG; Jing TAO

doi:10.3969/j.issn.1001-5256.2021.01.019

Volume 37 Issue 1

Jan. 2021

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2021 > 37(1): 94-98

PDF( 2049 KB)

Association of nonalcoholic fatty liver disease with the severity of hyperlipidemic acute pancreatitis

DOI: 10.3969/j.issn.1001-5256.2021.01.019

Department of Pancreatic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China

Received Date: 2020-07-11
Accepted Date: 2020-08-28
Published Date: 2021-01-20

Abstract

Abstract

Objective To investigate the association of nonalcoholic fatty liver disease (NAFLD) with the severity of hyperlipidemic acute pancreatitis (HLAP). Methods A retrospective analysis was performed for 895 patients with acute pancreatitis (AP) who were admitted to Department of Pancreatic Surgery in Renmin Hospital of Wuhan University from February 20, 2018 to January 20, 2020, among whom 101 patients with HLAP were screened out. According to the presence or absence of NAFLD, the 101 patients with HLAP were divided into non-NAFLD group with 41 patients and NAFLD group with 60 patients. Related clinical data were collected, including general information (sex, age, body mass index, diabetes, and hypertension), biochemical parameters (amylase, lipase, alanine aminotransferase, aspartate aminotransferase, albumin, total bilirubin, blood urea, serum creatinine, blood glucose, blood sodium, blood calcium, cholesterol, triglyceride, lactate dehydrogenase, and high-sensitivity C-reactive protein), white blood cell count (WBC), severity of AP, local complications under CT scan, systemic inflammatory response syndrome, bacteremia, organ failure, hospitalization, and recurrence of HLAP [length of hospital stay, rate of admission to the intensive care unit (ICU), 1-year recurrence rate of HLAP, and number of HLAP attacks within 1 year]. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results Compared with the non-NAFLD group, the NAFLD group had significantly higher blood glucose and WBC and a significantly lower blood sodium level on admission (Z=-2.241, t=2.187, t=-2.533, all P < 0.05). Compared with the non-NAFLD group, the NAFLD group had a significantly higher proportion of patients with severe AP (75.0% vs 53.7%, χ²= 4.968, P < 0.05), as well as significantly higher incidence rates of local complications, systemic inflammatory response syndrome, bacteremia, and respiratory failure (χ²=6.059, 4.611, 4.056, and 4.568, all P < 0.05). There was no significant difference in length of hospital stay between the two groups (P > 0.05), and the NAFLD group had a significantly higher rate of admission to the ICU than the non-NAFLD group (23.3% vs 7.3%, χ²= 4.463, P < 0.05). In addition, there were no significant differences in 1-year recurrence rate of HLAP and number of HLAP attacks within 1 year between the two groups (both P > 0.05). Conclusion NAFLD is significantly associated with the severity of HLAP, and furthermore, NAFLD may play an important role in the early severity assessment, disease progression, and prognosis prediction of HLAP.
- Non-alcoholic Fatty Liver Disease,
- Pancreatitis,
- Patient Acuity,
- Recurrence

FullText(HTML)

References(19)

References

[1]	MIKOLASEVIC I, MILIC S, ORLIC L, et al. Metabolic syndrome and acute pancreatitis[J]. Eur J Intern Med, 2016, 32: 79-83. DOI: 10.1016/j.ejim.2016.04.004
[2]	Pancreas Study Group, Chinese Society of Gastroenterology, Chinese Medical Association; Editorial Board of Chinese Journal of Pancreatology; Editorial Board of Chinese Journal of Digestion. Chinese guidelines for the management of acute pancreatitis (Shenyang, 2019)[J]. J Clin Hepatol, 2019, 35(12): 2706-2711. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2019.12.013 中华医学会消化病学分会胰腺疾病学组, 《中华胰腺病杂志》编辑委员会, 《中华消化杂志》编辑委员会. 中国急性胰腺炎诊治指南(2019, 沈阳)[J]. 临床肝胆病杂志, 2019, 35(12): 2706-2711. DOI: 10.3969/j.issn.1001-5256.2019.12.013
[3]	National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association; Fatty Liver Expert Committee, Chinese Medical Doctor Association. Guidelines of prevention and treatment for nonalcoholic fatty liver disease: A 2018 update[J]. J Clin Hepatol, 2018, 34(5): 947-957. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2018.05.007 中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34(5): 947-957. DOI: 10.3969/j.issn.1001-5256.2018.05.007
[4]	MIKOLASEVIC I, ORLIC L, POROPAT G, et al. Nonalcoholic fatty liver and the severity of acute pancreatitis[J]. Eur J Intern Med, 2017, 38: 73-78. DOI: 10.1016/j.ejim.2016.10.019
[5]	DELLA CORTE C, MOSCA A, MAJO F, et al. Nonalcoholic fatty pancreas disease and nonalcoholic fatty liver disease: More than ectopic fat[J]. Clin Endocrinol (Oxf), 2015, 83(5): 656-662. DOI: 10.1111/cen.12862
[6]	WU D, ZHANG M, XU S, et al. Nonalcoholic fatty liver disease aggravated the severity of acute pancreatitis in patients[J]. Biomed Res Int, 2019, 2019: 9583790. http://www.researchgate.net/publication/330561517_Nonalcoholic_Fatty_Liver_Disease_Aggravated_the_Severity_of_Acute_Pancreatitis_in_Patients
[7]	XU C, QIAO Z, LU Y, et al. Influence of fatty liver on the severity and clinical outcome in acute pancreatitis[J]. PLoS One, 2015, 10(11): e0142278. DOI: 10.1371/journal.pone.0142278
[8]	ANGULO P, HUI JM, MARCHESINI G, et al. The NAFLD fibrosis score: A noninvasive system that identifies liver fibrosis in patients with NAFLD[J]. Hepatology, 2007, 45(4): 846-854. DOI: 10.1002/hep.21496
[9]	BANKS PA, BOLLEN TL, DERVENIS C, et al. Classification of acute pancreatitis—2012: Revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1): 102-111. DOI: 10.1136/gutjnl-2012-302779
[10]	GAGLIO PJ. Nonaicoholic fatty liver disease preface[J]. Clin Liver Dis, 2016, 20(2): XIII-XIV. DOI: 10.1016/j.cld.2016.02.001
[11]	CALZADILLA BERTOT L, ADAMS LA. The natural course of non-alcoholic fatty liver disease[J]. Int J Mol Sci, 2016, 17(5): 774. DOI: 10.3390/ijms17050774
[12]	NIKNAM R, MORADI J, JAHANSHAHI KA, et al. Association between metabolic syndrome and its components with severity of acute pancreatitis[J]. Diabetes Metab Syndr Obes, 2020, 13: 1289-1296. DOI: 10.2147/DMSO.S249128
[13]	SZENTESI A, PÁRNICZKY A, VINCZE Á, et al. Multiple hits in acute pancreatitis: Components of metabolic syndrome synergize each other's deteriorating effects[J]. Front Physiol, 2019, 10: 1202. DOI: 10.3389/fphys.2019.01202
[14]	BLASZCZAK AM, KRISHNA SG, CONWELL DL, et al. Morbid obesity rather than metabolic syndrome impacts clinical outcomes of acute pancreatitis: A national survey[J]. Pancreas, 2019, 48(10): 1407.
[15]	HOU S, TANG X, CUI H, et al. Fatty liver disease is associated with the severity of acute pancreatitis:A systematic review and meta-analysis[J]. Int J Surg, 2019, 65: 147-153. DOI: 10.1016/j.ijsu.2019.04.003
[16]	MEI FC, YU J, WANG WX. Research progress of obesity with acute pancreatitis[J]. Chin J Pancreatol, 2019, 19(3): 225-227. (in Chinese) DOI: 10.3760/cma.j.issn.1674-1935.2019.03.021 梅方超, 余佳, 王卫星. 肥胖合并急性胰腺炎的研究进展[J]. 中华胰腺病杂志, 2019, 19(3): 225-227. DOI: 10.3760/cma.j.issn.1674-1935.2019.03.021
[17]	NDUMELE CE, NASIR K, CONCEIÇAO RD, et al. Hepatic steatosis, obesity, and the metabolic syndrome are independently and additively associated with increased systemic inflammation[J]. Arterioscler Thromb Vasc Biol, 2011, 31(8): 1927-1932. DOI: 10.1161/ATVBAHA.111.228262
[18]	BAFFY G. Kupffer cells in non-alcoholic fatty liver disease: The emerging view[J]. J Hepatol, 2009, 51(1): 212-223. DOI: 10.1016/j.jhep.2009.03.008
[19]	WANG Q, DU JJ, YU PF, et al. Hepatic steatosis depresses alpha-1-antitrypsin levels in human and rat acute pancreatitis[J]. Sci Rep, 2015, 5: 17833. DOI: 10.1038/srep17833

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Tables(3)

Get Citation

PDF

XML

Article Metrics

Article views (607) PDF downloads(63)

Association of nonalcoholic fatty liver disease with the severity of hyperlipidemic acute pancreatitis

DOI: 10.3969/j.issn.1001-5256.2021.01.019

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content