Clinical value of common laboratory indicators in assessing the severity of hyperlipidemia pancreatitis

Objective To investigate the value of common clinical laboratory indicators on the severity of hyperlipidemia acute pancreatitis (HLAP).

Methods The clinical data of 151 acute pancreatitis (AP) patients admitted to Gastroenterology Department of Songjiang Clinical College of Medicine of Nanjing Medical University were retrospectively analyzed, including 55 cases of mild HLAP (mild HLAP group), 44 cases of moderate or severe HLAP(moderate or severe HLAP group), and 52 cases of moderate or severe biliogenic acute pancreatitis (BAP) (moderate or severe BAP group). The laboratory indexes of HLAP in the two groups were compared within 48 h after admission, and the independent risk factors of moderate and severe HLAP were explored.

Results The monocyte, monocyte to lymphocyte ratio (MLR), apolipoprotein E levels of the moderate or severe HLAP group were higher than those in the mild HLAP group, while apolipoprotein A, prealbumin, albumin-to-globulin ratio(A/G), high density lipoprotein cholesterol (HDL) and serum calcium levels were lower than those in the mild group (P < 0.05). The analysis of multvariate binary Logistic regression model showed that prealbumin, A/G, high density lipoprotein and serum calcium were independent protective factors for moderate or severe HLAP, and monocyte was an independent risk factor for moderate or severe HLAP. Receiver operating characteristic (ROC) curve analysis showed that the areas under the curve (AUC) of serum calcium, A/G, monocyte, prealbumin and high density lipoprotein of moderate or severe HLAP were 0.75, 0.79, 0.71, 0.73, 0.67, respectively. The AUC of their combined detection was 0.92, with the specialty and sensitivity of 94.3% and 72.5%. The level of high density lipoprotein level in moderate or severe HLAP group was lower than that in moderate or severe BAP group, and the level of monocyte was higher than that in moderate or severe BAP group (P < 0.05).

Conclusion Serum calcium, A/G, monocyte, prealbumin, and high density lipoprotein cholesterol are independent predictors of moderate or severe HLAP, and their combined prediction can further enhance the clinical evaluation value for the prognosis of severity of HLAP.