Clinical features of hyperlipidemic acute pancreatitis and their association with lipid metabolism

• Main Author: AN Wenhui
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2020-04-01
• Series: Linchuang Gandanbing Zazhi
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=10689
• ISSN: 1001-5256; 1001-5256

ObjectiveTo investigate the clinical features of patients with hyperlipidemic acute pancreatitis (HLAP) and the association between lipid metabolism profile and HLAP. MethodsA total of 61 patients with HLAP who were treated in Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, from September 2017 to September 2019 were enrolled as HLAP group, and 77 patients with non-hyperlipidemic acute pancreatitis were as non-HLAP group. The clinical features of the two groups were analyzed, including baseline data, laboratory markers, disease grade, comorbidities, and severity score. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. The chi-square test was used to for comparison of categorical data between groups. A multivariate binary logistic regression analysis was used to investigate the independent risk factors for HLAP, and the Z test was used for comparison of the area under the ROC curve (AUC). ResultsThere were significant differences between the two groups in age (t=-6.125, P＜0.05), body mass index (t=4.125, P＜0.05), infection (χ2=4.364, P＜0.05), fatty liver disease (χ2=50.567, P＜0.05), diabetes (χ2=28408, P＜0.05), high-sensitivity C-reactive protein (Z=-2.456, P＜0.05), white blood cell count (t=2.652, P＜0.05), neutrophils (t=2.232, P＜0.05), lymphocytes (Z=-2.339, P＜0.05), D-dimer (Z=-8.601, P＜0.05), fasting blood glucose (Z=-4.416, P＜0.05), uric acid (t=4.644, P＜0.05), total cholesterol (Z=-8.937, P＜0.05), triglyceride (Z=-8.87, P＜005), low-density lipoprotein cholesterol (Z=-7.972, P＜0.05), non-high-density lipoprotein (Z=-9.085, P＜0.05), apolipoprotein B (Z=-3.244, P＜0.05), systemic inflammatory response syndrome score (Z=-2.817, P＜0.05), and Modified Early Warning Score (Z=-2.226, P＜0.05). Triglyceride (odds ratio ［OR］=0.675, 95% confidence interval ［CI］: 0.484-0.943, P=0.021) and non-high-density lipoprotein (OR=0.320, 95%CI: 0.164-0.624, P=0.001) were independent risk factors for HLAP. Non-high-density lipoprotein (AUC=0.951, sensitivity=100%, specificity=88.31%, 95%CI: 0.901-0.981, SE=0.020, Youden index=0.883) and triglyceride (AUC=0.940, sensitivity=95.08%, specificity=81.82%, 95% CI: 0.887-0.974, SE=0018, Youden index=0.769) had high diagnostic efficiency. Non-high-density lipoprotein with a cut-off value of ＞4.55 mmol/L had the highest diagnostic value. ConclusionHLAP often occurs in the population with metabolic syndrome, with a younger age of onset and more severe inflammatory response. Non-high-density lipoprotein has a high value in the diagnosis of HLAP, which provides a new idea for guiding clinical treatment.