The Effect of Admission Serum Triglyceride Level on the Prediction of Severity of Acute Pancreatitis in Pregnancy

Abstract

Purpose

Previous studies indicated that the serum triglyceride level in patients with acute pancreatitis positively correlated with the severity of the disease among the general population. Despite the physiological hypertriglyceridemia in pregnant women, there are no reports on the relationship between serum triglyceride level and the severity of acute pancreatitis in pregnant (APIP) women. This study explores the relationship between serum triglyceride levels and the severity of APIP.

Patients and Methods

Clinical information of APIP patients admitted to the Shengjing Affiliated Hospital of China Medical University was gathered from January 2012 to December 2020 to conduct retrospective research. The participating patients were divided into mild, moderately severe, and severe acute pancreatitis. The clinical outcomes of patients with different serum triglyceride levels (0–2.3 mmol/L, 2.23–5.65 mmol/L, 5.65–11.2 mmol/l, ≥11.2 mmol/L) were analyzed by performing ordinal logistic regression analysis. Receiver operating curve analysis was used to calculate the threshold value of serum triglyceride concentration that can effectively predict the occurrence of severe acute pancreatitis (SAP).

Results

Hypertriglyceridemic acute pancreatitis (HTG-AP) occurred in 47% of APIP patients within the group, with a high prevalence among the Han population. In the present study, the serum triglyceride concentration correlated positively with the severity of APIP (r=0.403, P < 0.05). The adjusted logistic model demonstrated that relative to nominal triglyceride levels, the OR value of SAP were 1.036 (95% CI: 0.401–2.677), 3.429 (95% CI: 1.269–9265), 8.329 (95% CI: 3.713–18.682) with triglyceride at the level of 2.23–5.65 mmol/L, 5.65–11.2 mmol/l and ≥11.2 mmol/L. In APIP patients, a triglyceride concentration of 10.7mmol/L or more upon admission was a predictive value for the occurrence of SAP, with a sensitivity of 0.72 and a specificity of 0.65, AUC: 0.708 (95% CI: 0.620–0.796).

Conclusion

As the serum triglyceride level upon admission increased, the frequency of local and systemic complications increased significantly.

Keywords:

• gestation
• hypertriglyceridemia
• acute pancreatitis
• organ failure

Ethics Statement

As a non-interventional retrospective studies, data was kept anonymous. The ethics committee passed our application for exemption from informed consent. We have obtained ethical approval to conduct the study, as well as permission from the electronic medical record database of the Shengjing Affiliated Hospital of China Medical University to use the information for the purpose of the research. Institutional ethical approval was obtained from the ethics committee of Shengjing Affiliated Hospital of China Medical University (Approval No 2019PS683K) on 11 DEC 2019 prior to the study. The study complied with the Declaration of Helsinki.

Acknowledgments

The authors declare that they have no proprietary, commercial, or financial interests that could be construed to have inappropriately influenced this study. This study was supported by the Natural Science Foundation of the Liaoning Province (20180530076) and Key Research and Development Joint Program of Liaoning Province (No.2020JH2/10300146). The study participants gave consents to have their data published. Institutional ethical approval was obtained from the ethics committee of Shengjing Affiliated Hospital of China Medical University (Approval No 2019PS683K) on 11 DEC 2019 and the study complied with the Declaration of Helsinki.

Disclosure

The authors report no conflicts of interest in this work.