Abstract
Background and Aim The incidence of nonalcoholic fatty liver disease (NAFLD) as a metabolic disease is increasing annually. In the present study, we aimed to explore the influence of NAFLD on the severity of acute pancreatitis (AP). Methods The severity of AP was diagnosed and analyzed according to the 2012 revised Atlanta Classification. Outcome variables, including the severity of AP, organ failure (all types of organ failure), and systemic inflammatory response syndrome (SIRS), were compared for patients with and without NAFLD. Results Six hundred and fifty-six patients were enrolled in the study and were divided into two groups according to the presence or absence of NAFLD. The non-NAFLD group contained 278 patients and the main etiology in this group was gallstone. The NAFLD group consisted of 378 patients and the main etiology was hyperlipidemia. The incidence of mild AP, moderately severe AP, and severe AP was 77.30%, 18.3%, and 4.3% in the non-NAFLD group and 58.2%, 33.9%, and 7.9% in the NAFLD group, respectively. There were significant differences between the two groups according to the severity of AP (P ≤ 0.001). In addition, the Ranson and BISAP scores as well as the incidence of SIRS and organ failure in the NAFLD group were higher than those in the non-NAFLD group (all P < 0.05). The patients were further divided into non-NAFLD, mild-NAFLD, and moderate-severe NAFLD (M+S-NAFLD) groups. The results showed that the severity of AP increased gradually from the non-NAFLD group to the M+S-NAFLD group. In addition, the incidence rates of SIRS and organ failure showed an upward trend with the aggravation of fatty liver severity. Multivariate logistic analysis showed that patients with NAFLD, especially those with M+S-NAFLD, had higher risks of SIRS and organ failure. Conclusions Compared with non-NAFLD, NAFLD has a clinically relevant impact on the severity of AP and may be an early prognostic parameter for patients with AP.
Highlights
Acute pancreatitis (AP) is an inflammatory disease of the pancreas, with 10–20% of patients progressing to multiple organ failure coupled with a high mortality rate
Patients suffering from cirrhosis, hepatocellular carcinoma, alcoholic fatty liver, or chronic pancreatitis as well as those who had undergone splenectomy, were pregnant, were younger than 18 or older than 60 years, had been hospitalized repeatedly, or had incomplete medical data were excluded from the analysis
The patients were divided into non-nonalcoholic fatty liver disease (NAFLD) (278 patients) and NAFLD (378 patients) groups based on the computed tomography (CT) results
Summary
Acute pancreatitis (AP) is an inflammatory disease of the pancreas, with 10–20% of patients progressing to multiple organ failure coupled with a high mortality rate. Metabolic syndrome is a clinical diagnosis based on the identification of related metabolic status It can increase the risk of cardiovascular diseases, including diabetes, dyslipidemia, arterial hypertension, and abdominal obesity [2]. The Ranson and BISAP scores as well as the incidence of SIRS and organ failure in the NAFLD group were higher than those in the non-NAFLD group (all P < 0.05). The results showed that the severity of AP increased gradually from the non-NAFLD group to the M+S-NAFLD group. The incidence rates of SIRS and organ failure showed an upward trend with the aggravation of fatty liver severity. Multivariate logistic analysis showed that patients with NAFLD, especially those with M+S-NAFLD, had higher risks of SIRS and organ failure.
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