Study On The Relationship Between Atherogenic Index Of Plasma And Systemic Inflammatory Response In Acute Pancreatitis

Objective:The atherogenic index of plasma(AIP)is a logarithmic conversion value[lg(TG/HDL-C)]of the ratio of plasma triglyceride(TG)to high-density lipoprotein cholesterol(HDL-C)levels(expressed in mmol/L)at the base of 10,which is a new blood lipid parameter that can comprehensively reflect the level of body lipid sub components.There are research reports that AIP can reflect changes in inflammation levels in patients with rheumatoid arthritis and Behcet’s disease.Acute pancreatitis(AP)is an inflammatory injury disease characterized by pancreatic edema,bleeding,and necrosis caused by various causes,often accompanied by lipid metabolism disorders.As the condition worsens,systemic inflammatory response syndrome(SIRS)and multiple organ dysfunction syndrome(MODS)appear.The relationship between AIP and the degree of inflammatory response in AP has been rarely reported.This study aims to explore the correlation between AIP and systemic inflammatory response in AP,providing valuable reference for clinical work.Methods:This study retrospectively analyzed 79 patients with acute pancreatitis who were hospitalized in the Internal Medicine Department of Jiangxi Provincial People’s Hospital from October 2021 to October 2022.Collect general information of selected patients,including laboratory indicators such as blood routine,blood biochemistry,and immunity(PCT)within 24 hours of admission.According to the New Japanese Acute Pancreatitis Severity Score(New JSS),the patients were divided into mild group(JSS score≤2 points)and severe group(JSS score≥3 points).Using independent sample t-test,Mann Whitney U andχ~2test were used for comparative analysis of inter group differences.Spearman correlation analysis was used to evaluate the correlation between AIP,procalcitonin,new JSS classification and other potential influencing factors.Select indicators related to JSS grading for multivariate logistic regression analysis.Exploring the correlation between AIP and PCT through multiple factor linear regression analysis.All data were statistically analyzed using SPSS 26.0.Results:(1)Compared with the mild acute pancreatitis group,the white blood cell count(15.3±5.3 109/L),AIP[0.9(0.2-1.3)],serum creatinine[102.0(75.0-239.5)mg/d L],and procalcitonin[5.9(1.3-6.6)ng/L]in the severe acute pancreatitis group significantly increased(all P<0.05),while high-density lipoprotein cholesterol(0.7±0.4 mmol/L),low-density lipoprotein cholesterol[1.7(1.1-2.6)mmol/L]significantly decreased(all P<0.05).(2)Spearman correlation analysis showed that AIP was positively correlated with hypertension history(r=0.222,P=0.049),triglycerides(r=0.938,P<0.001),total cholesterol(r=0.377,P<0.001),PCT(r=0.265,P=0.038),and new JSS grading(r=0.253,P=0.025);It was negatively correlated with age(r=-0.530,P<0.001),HDL-C(r=-0.813,P<0.001),cereal grass transaminase(r=-0.222,P=0.049),and glutamic pyruvic transaminase(r=-0.320,P=0.004).PCT was positively correlated with white blood cell count(r=0.378,P=0.002),AIP(r=0.265,P=0.038),alanine transaminase(r=0.077,P=0.038),and serum creatinine(r=0.262,P=0.040);It was negatively correlated with high-density lipoprotein cholesterol(r=-0.300,P=0.018).(3)In the multivariate logistic regression analysis,after adjusting for gender,age,BMI,smoking and drinking,hypertension history,diabetes history,low-density lipoprotein cholesterol,platelet count,glutamic oxaloacetic transaminase,glutamic transaminase,and PCT,the results showed that the increased AIP value was a risk factor for SAP in AP patients[β=1.459(95%CI:0.299,2.619),P=0.014].(4)In the multivariate linear regression analysis,after adjusting gender,age,BMI,smoking and drinking history,hypertension history,diabetes history,white blood cell count,alanine transaminase,and serum creatinine,the results showed that AIP value was positively correlated with PCT level[β=1.459(95%CI:0.299,2.619),P=0.014]。Conclusions:(1)Elevated AIP values were a risk factor for severe acute pancreatitis in the population.(2)The AIP value was positively correlated with the level of PCT in the population with acute pancreatitis.AIP can reflect the level of PCT and the level of systemic inflammatory response.