The Correlation Between Nonalcoholic Fatty Liver Disease And The Severity Of Acute Pancreatitis

ObjectivesTo explore the correlation between nonalcoholic fatty liver disease(NAFLD)and the severity of acute pancreatitis(AP).MethodsTotal 331 inpatients with AP in the department of digestive system and the intensive care unit of Fujian Provincal Hospital from January 2014 to September 2018were included.Gender,age,laboratory examination results,imaging results and pathography were collected.Independent sample t test and One-way anova were used for the normal distribution data.Rank sum test was used for the non-normal distribution data.Chi-square test was used for the contrast of count data.Multivariate ordinal logistic regression was used to analyze independent risk factors affecting the severity of AP.Chi-square linear trend test was used to analyze the relationship between the severity of NAFLD and AP.Linear regression and linear trend test was used to analyze the relationship between NAFLD severity and some indicators.Results1.In the comparison of mild acute pancreatitis(MAP),moderate acute pancreatitis(MSAP)and severe acute pancreatitis(SAP),the results of multivariate logistic regression analysis showed that C-reactive protein(CRP),serum calcium and NAFLD were independent risk factors affecting the severity of AP(all P<0.05).The higher the CRP(r=0.006),the lower the serum calcium(r=-2.144)and with NAFLD(r=1.177)means the severer AP.2.Compared with AP patients without NAFLD,the proportion of male patients and patients with diabetes was higher,while average age was younger than that in the group with NAFLD.The laboratory examination results including triglycerides(TG),CRP,fasting glucose,hemoglobin A1c(HbA1c)and white blood cell count(WBC)in the group AP with NAFLD was higher than that in the group AP without NAFLD,also the overall incidence of local complications and systemic complications.Modified CT severity index(MCTSI)scores in the group with NAFLD was higher than the other group.There were statistically significant differences between the two groups(all P<0.05).3.Chi-square linear trend test result showed that the AP condition aggravated with the severity of NAFLD(χ~2=8.605,P<0.05).4.In the comparison of mild NAFLD,moderate NAFLD and severe NAFLD,the proportion of patients with diabetes in severe NAFLD was higher than the other two groups.The results of linear regression analysis showed that with the increase of NAFLD severity,average age(r=-4.978)and blood amylase(r=-329.982)showed a decreasing trend,but hospitalization days(r=3.280),TG(r=2.866),CRP(r=25.320),fasting blood glucose(r=0.829)and HbA1c(r=0.462)showed an increasing trend.The results of linear trend test showed that the overall incidence of local complications and systemic complications,as well as the incidence of acute peripancreatic fluid collection(APFC)and systemic infection increased with the severity of NAFLD(all P<0.05),while no statistically significant differences were found in the incidence of other local complications and organ failure and MCTSI score among the three groups(all P>0.05).ConclusionsNonalcoholic fatty liver disease is an independent risk factor affecting the severity of acute pancreatitis,and the severity of acute pancreatitis is strongly associated with the severity of nonalcoholic fatty liver disease.