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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 6
Jun.  2023
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Article Contents

Influencing factors for dynamic changes in the severity of fatty liver in patients with acute pancreatitis and fatty liver

DOI: 10.3969/j.issn.1001-5256.2023.06.018
Research funding:

Seedling Project of Baotou Medical College (BYJJ-QM-201753)

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  • Corresponding author: ZHANG Lirong, yfyz_1466@163.com (ORCID: 0000-0002-6295-0605)
  • Received Date: 2022-10-23
  • Accepted Date: 2022-11-29
  • Published Date: 2023-06-20
  •   Objective  To investigate the dynamic change of fatty liver (FL) in patients with fatty liver-related acute pancreatitis (FLAP) and related influencing factors.  Methods  A total of 136 FLAP patients who were admitted to The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, from December 2017 to December 2021 were enrolled as subjects. With the first CT examination after admission as the starting point and the last CT examination before discharge as the ending point, the subjects were divided into FL aggravation group (FLAG group), FL mild mitigation group (FLMMG group), and FL significant mitigation group (FLSMG group) according to the degree of change in FL. General information and clinical data were compared between groups. General information included age, sex, length of hospital stay, etiology of acute pancreatitis (AP), and changes in body weight and temperature, and clinical data included treatment modality and the changes in laboratory markers and AP severity. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Mann-Whitney U test with Bonferroni correction was used for further comparison between two groups. Dynamic changes of data were expressed as the difference from the starting point to the ending point, and a covariance analysis was used for comparison of data with dynamic changes. The Spearman correlation analysis was used to investigate the correlation of indices with significant changes with the degree of change in FL.  Results  Among the 136 FLAP patients, 61 achieved mild mitigation of FL, 59 achieved significant mitigation of FL, and 16 experienced aggravation of FL at the ending point of the study. There were significant differences between the three groups in the length of hospital stay (χ2=16.215, P < 0.001) and the change in body weight (F=3.908, P < 0.05), and the FLSMG group had a greater reduction in body weight and a longer length of hospital stay. There were also significant differences between the three groups in the number of fasting days (χ2=11.020, P=0.004) and the degree of changes in C-reactive protein (CRP) (F=8.589, P < 0.001), white blood cell count (WBC) (F=5.448, P=0.005), and CT severity index (CTSI) (F=7.544, P=0.001), and the FLSMG group had greater reductions in CRP, WBC, and CTSI and a longer duration of fasting. Length of hospital stay, number of fasting days, and changes in CRP and CTSI were significantly correlated with the change in FL (r=0.352, 0.372, -0.365, and -0.350, all P < 0.001).  Conclusion  Most FLAP patients tend to have mitigation of FL, and its dynamic changes are closely associated with the changes in CRP and CTSI.

     

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  • [1]
    LI CL, JIANG M, PAN CQ, et al. The global, regional, and national burden of acute pancreatitis in 204 countries and territories, 1990-2019[J]. BMC Gastroenterol, 2021, 21(1): 332. DOI: 10.1186/s12876-021-01906-2.
    [2]
    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. DOI: 10.1155/2019/9583790.
    [3]
    SONG Y, ZHANG P, XU SW, et al. Predictive value of CT evaluation of fatty liver for the severity of acute pancreatitis[J]. Chin J Postgrad Med, 2018, 41(8): 701-705. DOI: 10.3760/cma.j.issn.1673-4904.2018.08.008.

    宋宇, 张鹏, 许尚文, 等. CT评估脂肪肝对急性胰腺炎严重程度的预测价值[J]. 中国医师进修杂志, 2018, 41(8): 701-705. DOI: 10.3760/cma.j.issn.1673-4904.2018.08.008.
    [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]
    YOON SB, LEE IS, CHOI MH, et al. Impact of fatty liver on acute pancreatitis severity[J]. Gastroenterol Res Pract, 2017, 2017: 4532320. DOI: 10.1155/2017/4532320.
    [6]
    JIANG MK, ZHANG M, ZHANG LR, et al. Impact of fatty liver on acute pancreatitis severity and prognosis: A meta-analysis of English and Chinese studies[J]. Radiol Infect Dis, 2021, 8(4): 140-149. DOI: 10.4103/RID.RID_10_22.
    [7]
    VÁNCSA S, NÉMETH D, HEGYI P, et al. Fatty liver disease and non-alcoholic fatty liver disease worsen the outcome in acute pancreatitis: A systematic review and Meta-analysis[J]. J Clin Med, 2020, 9(9): 2698. DOI: 10.3390/jcm9092698.
    [8]
    ZHANG M, ZHANG LR, LUO L, et al. Influence of fatty liver on the severity of acute pancreatitis[J]. J Clin Hepatol, 2022, 38(7): 1595-1601. DOI: 10.3969/j.issn.1001-5256.2022.07.025.

    张苗, 张利荣, 罗琳, 等. 合并脂肪肝对急性胰腺炎严重程度的影响[J]. 临床肝胆病杂志, 2022, 38(7): 1595-1601. DOI: 10.3969/j.issn.1001-5256.2022.07.025.
    [9]
    Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association. Guidelines for diagnosis and treatment of acute pancreatitis in China (2021)[J]. Chin J Surg, 2021, 59(7): 578-587. DOI: 10.3760/cma.j.cn112139-20210416-00172.

    中华医学会外科学分会胰腺外科学组. 中国急性胰腺炎诊治指南(2021)[J]. 中华外科杂志, 2021, 59(7): 578-587. DOI: 10.3760/cma.j.cn112139-20210416-00172.
    [10]
    SUREKA B, BANSAL K, PATIDAR Y, et al. Imaging lexicon for acute pancreatitis: 2012 Atlanta Classification revisited[J]. Gastroenterol Rep (Oxf), 2016, 4(1): 16-23. DOI: 10.1093/gastro/gov036.
    [11]
    ZENG MD, FAN JG, LU LG, et al. Guidelines for the diagnosis and treatment of nonalcoholic fatty liver diseases[J]. J Dig Dis, 2008, 9(2): 108-112. DOI: 10.1111/j.1751-2980.2008.00331.x.
    [12]
    Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel Ⅲ)[J]. JAMA, 2001, 285(19): 2486-2497. DOI: 10.1001/jama.285.19.2486.
    [13]
    SU L, LI Y. Antimicrobial therapy in patients with acute pancreatitis complicated with infection[J]. J Med Postgra, 2017, 30(7): 684-692. DOI: 10.16571/j.cnki.1008-8199.2017.07.003.

    苏磊, 李悦. 急性胰腺炎合并感染的抗生素应用[J]. 医学研究生学报, 2017, 30(7): 684-692. DOI: 10.16571/j.cnki.1008-8199.2017.07.003.
    [14]
    WU D, SONG LL, ZHAO YH. Study on the relationship between fatty liver and classification of acute pancreatitis[J]. Chin J Lab Diag, 2018, 22(9): 1557-1559. DOI: 10.3969/j.issn.1007-4287.2018.09.023.

    吴迪, 宋玲玲, 赵艳辉. 脂肪肝与急性胰腺炎分级的关系研究[J]. 中国实验诊断学, 2018, 22(9): 1557-1559. DOI: 10.3969/j.issn.1007-4287.2018.09.023.
    [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]
    LI J, TIAN T, HU WW, et al. Concomitant nonalcoholic fatty liver disease affects the severity and clinical outcome of acute pancreatitis[J]. Chin J Clinicians, 2021, 49(4): 456-459. DOI: 10.3969/j.issn.2095-8552.2021.04.024.

    李吉, 田甜, 胡文炜, 等. 合并非酒精性脂肪性肝病影响急性胰腺炎严重程度和临床结局[J]. 中国临床医生杂志, 2021, 49(4): 456-459. DOI: 10.3969/j.issn.2095-8552.2021.04.024.
    [17]
    YAN YF, JIANG X, ZHONG R, et al. Clinical features and prognosis of acute pancreatitis with nonalcoholic fatty liver disease[J]. J Clin Hepatol, 2020, 36(5): 1091-1096. DOI: 10.3969/j.issn.1001-5256.2020.05.028.

    严永峰, 蒋鑫, 钟瑞, 等. 急性胰腺炎合并非酒精性脂肪性肝病的临床特征及预后分析[J]. 临床肝胆病杂志, 2020, 36(5): 1091-1096. DOI: 10.3969/j.issn.1001-5256.2020.05.028.
    [18]
    FISIC E, POROPAT G, BILIC-ZULLE L, et al. The role of IL-6, 8, and 10, sTNFr, CRP, and pancreatic elastase in the prediction of systemic complications in patients with acute pancreatitis[J]. Gastroenterol Res Pract, 2013, 2013: 282645. DOI: 10.1155/2013/282645.
    [19]
    ZHANG M, ZHANG LR, LUO L, et al. Analysis of influence factors of serum CRP level in early onset of acute pancreatitis[J]. J Baotou Med Coll, 2021, 37(10): 71-76. DOI: 10.16833/j.cnki.jbmc.2021.10.017.

    张苗, 张利荣, 罗琳, 等. 急性胰腺炎发病早期血清C-反应蛋白水平影响因素分析[J]. 包头医学院学报, 2021, 37(10): 71-76. DOI: 10.16833/j.cnki.jbmc.2021.10.017.
    [20]
    LI X, KE L, DONG J, et al. Significantly different clinical features between hypertriglyceridemia and biliary acute pancreatitis: a retrospective study of 730 patients from a tertiary center[J]. BMC Gastroenterol, 2018, 18(1): 89. DOI: 10.1186/s12876-018-0821-z.
    [21]
    SZATMARY P, GRAMMATIKOPOULOS T, CAI W, et al. Acute pancreatitis: diagnosis and treatment[J]. Drugs, 2022, 82(12): 1251-1276. DOI: 10.1007/s40265-022-01766-4.
    [22]
    PÁRNICZKY A, LANTOS T, TÓTH EM, et al. Antibiotic therapy in acute pancreatitis: From global overuse to evidence based recommendations[J]. Pancreatology, 2019, 19(4): 488-499. DOI: 10.1016/j.pan.2019.04.003.
    [23]
    LUO YY, LIU X. Research progress of probiotics in adjuvant treatment of severe acute pancreatitis[J]. Trauma Crit Care Med, 2021, 9(2): 161-164. DOI: 10.16048/j.issn.2095-5561.2021.02.22.

    罗娅媛, 刘旭. 益生菌辅助治疗重症急性胰腺炎研究进展[J]. 创伤与急危重病医学, 2021, 9(2): 161-164. DOI: 10.16048/j.issn.2095-5561.2021.02.22.
    [24]
    MORAN RA, HALLORAN C, GUO Q, et al. Early infection is an independent risk factor for increased mortality in patients with culture-confirmed infected pancreatic necrosis[J]. Pancreatology, 2022, 22(1): 67-73. DOI: 10.1016/j.pan.2021.11.003.
    [25]
    Professional Committee of Pancreatic Disease, Chinese Medical Doctor Association. Chinese consensus on the multidisciplinary treatment (MDT) of acute pancreatitis[J]. J Clin Hepatol, 2015, 31(11): 1770-1775. DOI: 10.3969/j.issn.1001-5256.2015.11.003.

    中国医师协会胰腺病学专业委员会. 中国急性胰腺炎多学科诊治共识意见[J]. 临床肝胆病杂志, 2015, 31(11): 1770-1775. DOI: 10.3969/j.issn.1001-5256.2015.11.003.
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