Value of neutrophil-lymphocyte ratio combined with apolipoprotein A-I level in predicting the severity of acute pancreatitis in the early stage after admission

Jin XU; Yan PENG; Chuankang TANG

doi:10.3969/j.issn.1001-5256.2021.03.030

Volume 37 Issue 3

Mar. 2021

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Article Navigation > Journal of Clinical Hepatology > 2021 > 37(3): 660-665

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Value of neutrophil-lymphocyte ratio combined with apolipoprotein A-I level in predicting the severity of acute pancreatitis in the early stage after admission

DOI: 10.3969/j.issn.1001-5256.2021.03.030

Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China

Received Date: 2020-10-08
Accepted Date: 2020-10-30
Published Date: 2021-03-20

Abstract

Abstract

Objective To investigate the value of neutrophil-lymphocyte ratio (NLR) combined with apolipoprotein A-I (ApoA-I) level in predicting the severity of acute pancreatitis (AP). Methods A retrospective analysis was performed for 460 patients with AP who were admitted to The Affiliated Hospital of Southwest Medical University from January 2015 to December 2019, among whom 250 had mild acute pancreatitis (MAP), 166 had moderate-severe acute pancreatitis, and 44 had severe acute pancreatitis (SAP). Related clinical data were collected, including basic information, laboratory markers (neutrophil count, lymphocyte count, serum triglyceride, serum total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, ApoA-I, and apolipoprotein B), and scores (Ranson, BISAP, and MCTSI). A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between multiple groups; a logistic regression analysis was performed for the variables with statistical significance in univariate analysis; a Spearman correlation analysis was performed to investigate the correlation between data. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of indices, and MedCalc software was used to investigate whether there was a significant difference in diagnostic efficiency. Results There were significant differences in NLR and ApoA-I level between the groups with different severities of AP (χ²= 64.124, F=40.277, P < 0.001). On admission, NLR was positively correlated with Atlanta grading, Ranson score, MCTSI score, and BISAP score (r=0.370, 0.129, 0.260, and 0.122, all P < 0.05), and ApoA-I level was negatively correlated with Atlanta grading, Ranson score, MCTSI score, and BISAP score (r=-0.358, -0.220, -0.297, and -0.251, all P < 0.05). NLR was an independent risk factor for non-MAP (odds ratio [OR]=1.104, 95% confidence interval [CI]: 1.070-1.140, P < 0.001), while ApoA-I was an independent protective factor against non-MAP (OR=0.138, 95% CI: 0.070-0.264, P < 0.001); NLR was an independent risk factor for SAP (OR=1.163, 95% CI: 1.107-1.222, P < 0.001), while ApoA-I was an independent protective factor against SAP (OR=0.013, 95% CI: 0.003-0.056, P < 0.001). NLR had an area under the ROC curve (AUC) of 0.700 (95% CI: 0.656-0.742, P < 0.001) in predicting non-MAP; ApoA-I had an AUC of 0.684 (95% CI: 0.640-0.726, P < 0.001) in predicting non-MAP; NLR combined with ApoA-I had an AUC of 0.748 (95%CI: 0.706-0.787, P < 0.001) in predicting non-MAP. NLR combined with ApoA-I had a better value than NLR or ApoA-I alone in predicting non-MAP (Z=3.439 and 2.462, both P < 0.05). NLR had an AUC of 0.752 (95% CI: 0.710-0.791, P < 0.001) in predicting SAP; ApoA-I had an AUC of 0.797 (95% CI: 0.757-0.833, P < 0.001) in predicting SAP; NLR combined with ApoA-I had an AUC of 0.857 (95% CI: 0.822-0.888, P < 0.001) in predicting SAP. NLR combined with ApoA-I had a better value than NLR or ApoA-I alone in predicting SAP (Z=3.171 and 2.630, both P < 0.05). Conclusion NLR combined with ApoA-I can be used as a good indicator for predicting the severity of AP in the early stage after admission.
- Pancreatitis,
- Neutrophil and Lymphocyte Ratio,
- Apolipoprotein A-I,
- Severity of Illness Index

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Value of neutrophil-lymphocyte ratio combined with apolipoprotein A-I level in predicting the severity of acute pancreatitis in the early stage after admission

DOI: 10.3969/j.issn.1001-5256.2021.03.030

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