| Objective: To study the relationship between triglyceride(TG)levels and clinical characteristics in patients with acute pancreatitis(AP),and the correlation between TG levels and serum amylase(AMY)levels.Methods: Case data of patients diagnosed with AP at the Affiliated Hospital of Yan’an University were retrospectively collected between 2019.1.1 and 2021.12.31.According to the inclusion and exclusion criteria,340 patients with AP were finally included as the study population.The patients were grouped according to etiology and TG level within 24 h of admission: TG <1.7 mmol/L was divided into NHNT group(156cases),non-HTG-AP with TG >1.7 mmol/L was divided into NHET group(94 cases),and HTG-AP diagnostic criteria were met into HTG-AP group(90 cases).The time from onset to admission,gender,age,past medical history,history of alcohol consumption,history of smoking,serum amylase(AMY),serum lipase(LPS),high-density lipoprotein cholesterol(HDL-C),total cholesterol(TC),fasting blood glucose(FBG),blood urea nitrogen(BUN),creatinine(CRE),RAC classification,and complications were statistically analyzed in the three groups of AP patients.Logistic regression was applied to analyze whether TG was an influencing factor for serum amylase(AMY)less than three times the upper limit of normal(ULN).Results:1.Gender comparison: gender comparison: 75 male patients(48.1%)and 81 female patients(51.9%)in the NHNT group;66 male patients(70.2%)and 28 female patients(29.8%)in the NHET group;84 male patients(93.3%)and 6 female patients(6.7%)in the HTG-AP group,the composition of the three groups of AP patients’ gender there was a significant difference in the composition of the three groups of AP patients by gender(P< 0.001).In a two-by-two comparison between groups,the percentage of male patients in the NHET and HTG-AP groups was higher than that in the NHNT group,and the percentage of male patients in the HTG-AP group was higher than that in the NHET group(P < 0.017).2.Age comparison: the median age was 56 years in the NHNT group,42 years in the NHET group,and 35 years in the HTG-AP group,with a significant difference in the overall age distribution of AP patients in the three groups(P < 0.001).In a two-by-two comparison between groups,the median age in the NHNT group was higher than that in the NHET and HTG-AP groups,and the median age in the NHET group was higher than that in the HTG-AP group(P < 0.017).3.Comparison of onset to admission,past medical history,smoking history and drinking history:the proportion of the NHET group and HTG-AP combination with fatty liver was higher than that of the NHNT group,and the proportion of the HTG-AP combination with fatty liver was higher than that of the NHET group(P < 0.017);the proportion of the HTG-AP combination with diabetes was higher than that of the other two groups,and the proportion of the NHET combination with diabetes was higher than that of the NHNT group(P < 0.017);the proportion of the HTG-AP combination with obesity was higher than that of the other two groups(P < 0.017).The HTG-AP group with a history of obesity was higher than the other two groups(P < 0.017);the NHET and HTG-AP groups had a higher percentage of history of alcohol consumption than the NHNT group,and the HTG-AP group had a higher percentage of history of alcohol consumption than the NHET group(P < 0.017);the NHET and HTG-AP groups had a higher percentage of history of alcohol consumption than the NHNT group(P < 0.017);the HTG-AP group had a higher percentage of history of alcohol consumption than the NHNT group(P < 0.017).The proportion of smoking history was higher in the NHET and HTG-AP groups than in the NHNT group(P < 0.017);there was no significant difference between the three groups of AP patients from onset to admission(P > 0.05).4.Comparison of condition scores,RAC classification,and complications: there were no statistically significant differences in MCTSI scores,BISAP scores,RAC classification,and complications among the three groups of AP patients(P > 0.05).5.Comparison of laboratory indices: TC in the HTG-AP and NHET groups was higher than that in the NHNT group,and TC in the HTG-AP group was higher than that in the NHET group;HDL-C in the HTG-AP group was lower than that in the other two groups,and HDL-C in the NHET group was lower than that in the NHNT group;FBG in the HTG-AP group was higher than that in the other two groups;AMY in both the NHET and HTG-AP groups was lower than that in the The AMY of both NHET and HTG-AP groups was lower than that of the NHNT group,and the AMY of both NHET and HTG-AP groups was lower than that of the HTG-AP group;the LPS of both NHET and HTG-AP groups was lower than that of the NHNT group(P < 0.017).6.Comparison of AMY diagnostic AP sensitivity: the percentage of AMY ≥ 3ULN was lower in both the NHET and HTG-AP groups than in the NHNT group(P <0.017).7.Analysis of factors influencing the occurrence of AMY <3ULN in patients with AP: The results of univariate analysis revealed that whether or not there was a history of combined diabetes,whether or not there was a history of combined fatty liver,onset to admission,TC,and HTG-AP were factors influencing the occurrence of AMY <3ULN(P< 0.05).After correcting for factors related to(time to admission,fatty liver,diabetes,TC,HDL-C,etc.),the results showed that the NHET group was 2.211 times more likely to have AMY <3ULN than the NHNT group [95% CI(1.226～3.987),(P=0.008<0.05)],and the HTG-AP group was 2.382 times more likely to have AMY <3ULN than the NHNT group.The likelihood of AMY <3ULN in the HTG-AP group was 2.382 times higher than that in the NHNT group [95% CI(1.087～5.219),(P=0.030<0.05)].Conclusion:1.Patients with HTG-AP are more likely to be young,smokers,alcohol drinkers,and obese men.2.Patients with combined diabetes mellitus and fatty liver were more prevalent in AP with elevated TG.3.In AP patients with elevated TG,AMY is not significantly elevated,and the sensitivity of AMY diagnosis will be reduced;4.There was no significant correlation between TG levels and disease scores,severity,and incidence of complications in AP patients. |
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