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Background: Obesity substantially contributes to the onset of acute pancreatitis (AP) and influences its progression to severe AP. Although body mass index (BMI) is a widely used anthropometric parameter, it fails to delineate the distribution pattern of adipose tissue. To circumvent this shortcoming, the predictive efficacies of novel anthropometric indicators of visceral obesity, such as lipid accumulation products (LAP), cardiometabolic index (CMI), body roundness index (BRI), visceral adiposity index (VAI), A Body Shape Index (ABSI), and Chinese visceral adiposity index (CVAI) were examined to assess the severity of AP., Method: The body parameters and laboratory indices of 283 patients with hyperlipidemic acute pancreatitis (HLAP) were retrospectively analysed, and the six novel anthropometric indicators of visceral obesity were calculated. The severity of HLAP was determined using the revised Atlanta classification. The correlation between the six indicators and HLAP severity was evaluated, and the predictive efficacy of the indicators was assessed using area under the curve (AUC). The differences in diagnostic values of the six indicators were also compared using the DeLong test., Results: Patients with moderate to severe AP had higher VAI, CMI, and LAP than patients with mild AP (all P < 0.001). The highest AUC in predicting HLAP severity was observed for VAI, with a value of 0.733 and 95% confidence interval of 0.678-0.784., Conclusions: This study demonstrated significant correlations between HLAP severity and VAI, CMI, and LAP indicators. These indicators, particularly VAI, which displayed the highest predictive power, were instrumental in forecasting and evaluating the severity of HLAP., (© 2024. The Author(s).)

Background: The incidence of acute pancreatitis caused by hyperlipidaemia is increasing. A quick and easy diagnosis of the severity of hyperlipidaemic acute pancreatitis (HTGP) is important to improve patient prognosis and reduce mortality. Previous studies reported that insulin resistance (IR) is associated with acute pancreatitis. Our study aimed to investigate the correlation between the triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio and HTGP., Methods: Patients' laboratory and clinical parameters were obtained from the institutional pancreatitis database. Univariate and multivariate logistic regression analyses were applied to evaluate the risk factors for the severity of HTGP and the efficacy of four clinical scoring systems: Ranson's Criteria, Acute Physiology and Chronic Health Evaluation II (APACHE II), the Bedside Index for Severity in Acute Pancreatitis (BISAP), and Marshall., Results: Of 290 patients, 134 (46.2%) were diagnosed with moderately severe to severe HTGP. The TG/HDL-C ratio was higher in the moderately severe to severe HTGP subgroup than in the mild HTGP subgroup. Among the independent risk factors, such as amylase, albumin, aspartate transaminase (AST), systemic inflammatory response syndrome (SIRS), and TG/HDL-C ratio, the TG/HDL-C ratio had the highest area under the curve (AUC) (0.727, 95% CI, 0.571-0.701). In comparison with other clinical scoring systems, the TG/HDL-C ratio has a relatively preferable predictive ability., Conclusion: Our findings suggest that the TG/HDL-C ratio is positively correlated with HTGP severity and could be used as a simple indicator of severe HTGP., (© 2022 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)

Background: Body composition parameters are associated with hypertriglyceridemia-induced pancreatitis (HTGP). This study investigated the association between the quantity of muscle assessed using computed tomography (CT) and the severity of HTGP., Methods: The modified CT severity index (MCTSI) was calculated from admission examination data. Patients' characteristics and body composition parameters were collected. Univariate and multivariate logistic regression analyses were also performed. The receiver operating characteristic curves and corresponding area under the curves (AUC) were calculated to test the efficiency of the model. A nomogram was then constructed., Results: Of the 175 included patients, 138 were male, of which 85 had moderately severe to severe HTGP. Patients with low skeletal muscle mass (LSMM) and high MCTSI were significantly more likely to have moderately severe to severe HTGP. Patients with LSMM had lower body mass index, lower HDL-C level, higher amylase level, prevalence of surgery, shorter umbilical waist circumference, and longer length of hospital stay. Univariate and multivariate logistic regression analyses confirmed that female sex, lipase, total cholesterol, LSMM-MCTSI (P = .004, odds ratio = 23.105), and albumin were risk factors. The TOTAL model that combined LSMM-MCTSI and clinical risk parameters performed best (AUCs = 0.875), followed by other models (LSMM-MCTSI: AUCs = 0.762, MCTSI: AUCs = 0.728). The Delong test revealed significant difference. Finally, a nomogram was developed to predict the severity of HTGP., Conclusion: The performance of MCTSI in predicting severity can be improved by considering LSMM, which is a promising strategy for the treatment of HTGP., (© 2022 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)

It is important to clarify the severity of acute pancreatitis (AP) in the early stages of the disease. The visceral adiposity index (VAI), calculated using the waist circumference (WC), body mass index (BMI), triglyceride (TG) levels, and high-density lipoprotein cholesterol (HDL-c), indirectly reflects visceral adiposity function and can be used to explore its value in evaluating and predicting the severity of hyperlipidaemic acute pancreatitis (HLAP). The VAIs of 227 patients with HLAP were calculated by retrospective analysis of body parameters and laboratory indicators. The correlation between the VAI and HLAP severity, local complications, and systemic inflammatory response syndrome (SIRS) response was analysed. The VAI was significantly higher in patients with severe and moderately severe AP than in patients with mild AP (both p < 0.05). Length of hospital stay (LOS), AP severity, systemic complications, Acute Physiology and Chronic Health Evaluation II (APACHE-II) score, and SIRS score were significantly correlated with the VAI in HLAP patients. The VAI had the highest area under the curve of receiver operating characteristics (ROC) (0.755, 95% confidence interval [CI], 0.691-0.819) for predicting AP severity. The multivariate-adjusted odds ratio (HR) for the VAI in the relationship of body parameters and the severity of HLAP was 3.818 (95% CI, 1.395-10.452). Our study shows that the VAI is a valuable indicator for predicting and assessing the severity of hyperlipidaemic acute pancreatitis. Its increase is closely related to poor prognosis in patients with HLAP., (© 2021. Società Italiana di Medicina Interna (SIMI).)

Background: Analytic morphometric assessment has recently been proposed to be applied to the study of acute pancreatitis (AP). However, the relationship between body composition and the outcomes of hypertriglyceridemic pancreatitis (HTGP) is still unclear. The aim of this study was to evaluate body composition in relation to the length of hospital stay (LOS) and recurrence of HTGP. Methods: Patient characteristics, admission examination data, body composition parameters, LOS, and recurrence within 1 year were collected from the institutional pancreatitis database and follow-up records. Logistic regression analysis was used to identify risk factors for LOS and recurrence of HTGP. Results: Of the 196 included patients, 158 (80.6%) were men and 53 (27.0%) were sarcopenic. The average LOS was 15.83± 10.02 days. The recurrence rate of HTGP was 36.7%. Multivariate analysis with multiple linear regression suggested that subcutaneous adipose tissue (SAT) area (p=0.019) and high-density lipoprotein-cholesterol (HDL-C) (p=0.001) were independently associated with the LOS for HTGP after adjusting for age and sex. The multivariate adjusted hazard ratios for SAT area and HDL-C, with respect to the relationship between body parameters and LOS, were 1.008 (95% confidence interval [CI], 1.001– 1.015) and 0.090 (95% CI, 0.022– 0.361), respectively. No significant differences were observed between the AP and recurrent AP (RAP) groups in terms of characteristics, admission examination data, and body composition parameters. Conclusion: SAT area and HDL-C are associated with LOS in patients with HTGP. The body composition of patients at the first symptom onset of HTGP cannot predict recurrence. [ABSTRACT FROM AUTHOR]