Impact of metabolic syndrome components on clinical outcomes in hypertriglyceridemia-induced acute pancreatitis

doi:10.3748/wjg.v30.i35.3996

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Sep 21, 2024; 30(35): 3996-4010
Published online Sep 21, 2024. doi: 10.3748/wjg.v30.i35.3996

Table 1 Patient characteristics at baseline, n (%)

Characteristic	All (n = 255)
Age (years), mean ± SD	40.2 ± 8.9
Sex
Male	195 (76.5)
Female	60 (23.5)
BMI (kg/m²), mean ± SD	26.7 ± 3.9
History of hypertension	42 (16.5)
History of diabetes	60 (23.5)
Pleural effusion	129 (50.6)
Peritoneal effusion	78 (30.6)
Localized complications	183 (71.8)
APFC	62 (24.3)
ANC	93 (36.5)
PPC	17 (6.7)
WON	3 (1.2)
IPN	8 (3.1)
Systemic complications	135 (52.9)
Respiratory failure	53 (20.8)
Renal failure	39 (15.3)
Circulatory failure	16 (6.3)
SIRS	123 (48.2)
Sepsis	17 (6.7)
ACS	22 (8.6)
ARDS	16 (6.3)
MODS	32 (12.5)
Grades of severity
MAP	72 (28.2)
MSAP	126 (49.4)
SAP	57 (22.4)
ICU admission	54 (21.2)
Length of hospital stays (days), median (IQR)	10 (6, 14)
Total costs (thousand CNY), median (IQR)	19.7 (11.0, 37.8)
Mortality	2 (0.78)

IQR: Interquartile range; BMI: Body mass index; APFC: Acute peripancreatic fluid collection; ANC: Acute necrotic collection; PPC: Pancreatic pseudocyst; WON: Walled-off necrosis; IPN: Infected pancreatic necrosis; SIRS: Systemic inflammatory response syndrome; ACS: Abdominal compartment syndrome; ARDS: Acute respiratory distress syndrome; MODS: Multiple organ dysfunction syndrome; MAP: Mild acute pancreatitis; MSAP: Moderately severe acute pancreatitis; SAP: Severe acute pancreatitis; CNY: China yuan; ICU: Intensive care unit.

Table 2 Impact of individual metabolic syndrome components on adverse clinical outcomes in hypertriglyceridemia-acute pancreatitis

Outcome	Obesity		Hyperglycaemia		Hypertension		Low HDL-C
Outcome	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value
Pleural effusion	1.52 (0.89-2.61)	0.129	1.75 (0.88-3.46)	0.109	1.12 (0.69-1.84)	0.644	2.57 (1.55-4.27)	< 0.001^a
Peritoneal effusion	0.98 (0.55-1.75)	0.941	1.44 (0.67-3.11)	0.349	1.20 (0.70-2.05)	0.505	3.02 (1.70-5.36)	< 0.001^a
Localized complications	2.07 (1.07-4.00)	0.031^a	3.04 (1.53-6.06)	0.002^a	0.82 (0.47-1.42)	0.476	2.06 (1.18-3.59)	0.011^a
APFC	2.73 (1.50-4.96)	0.001^a	2.61 (0.98-6.99)	0.055	0.96 (0.54-1.71)	0.889	0.82 (0.46-1.46)	0.499
ANC	1.02 (0.59-1.79)	0.963	1.47 (0.71-3.05)	0.298	0.75 (0.45-1.25)	0.271	2.32 (1.37-3.94)	0.002^a
PPC	0.48 (0.13-1.74)	0.484	0.89 (0.24-3.24)	0.855	1.45 (0.54-3.89)	0.461	0.58 (0.21-1.58)	0.288
Systemic complications	1.81 (1.05-3.14)	0.034^a	2.86 (1.40-5.82)	0.004^a	1.81 (1.09-2.98)	0.021^a	2.38 (1.43-3.93)	0.001^a
Respiratory failure	2.16 (1.15-4.04)	0.016^a	2.08 (0.77-5.60)	0.146	1.40 (0.76-2.57)	0.276	4.94 (2.35-10.37)	< 0.001^a
Renal failure	2.06 (1.02-4.14)	0.044^a	2.56 (0.75-8.75)	0.133	0.85 (0.43-1.71)	0.654	3.40 (1.54-7.49)	0.002^a
Circulatory failure	1.08 (0.36-3.21)	0.896	3.02 (0.39-23.48)	0.292	0.55 (0.19-1.64)	0.283	2.74 (0.86-8.73)	0.089
SIRS	1.39 (0.81-2.37)	0.235	3.04 (1.53-6.06)	0.002^a	1.84 (1.12-3.03)	0.017	1.76 (1.07-2.90)	0.026^a
Sepsis	0.71 (0.22-2.25)	0.560	1.47 (0.32-6.69)	0.618	1.13 (0.42-3.02)	0.814	2.99 (0.95-9.43)	0.062
ACS	1.11 (0.43-2.84)	0.829	1.23 (0.35-4.38)	0.745	1.57 (0.65-3.78)	0.315	2.47 (0.93-6.53)	0.069
ARDS	1.92 (0.69-5.35)	0.214	1.37 (0.30-6.25)	0.688	1.28 (0.46-3.51)	0.637	4.02 (1.12-14.47)	0.033^a
MODS	1.74 (0.81-3.73)	0.156	3.18 (0.73-13.86)	0.124	0.84 (0.40-1.79)	0.654	3.54 (1.47-8.52)	0.005^a
SAP	1.85 (1.00-3.43)	0.050	1.83 (0.73-4.59)	0.201	1.17 (0.65-2.12)	0.598	4.32 (2.16-8.66)	< 0.001^a
ICU admission	1.69 (0.90-3.17)	0.102	2.14 (0.80-5.74)	0.132	1.47 (0.80-2.69)	0.211	3.91 (1.94-7.85)	< 0.001^a

^aP < 0.05.

Adjusted for age and sex. OR: Odds ratio; HDL-C: High-density lipoprotein cholesterol; APFC: Acute peripancreatic fluid collection; ANC: Acute necrotic collection; PPC: Pancreatic pseudocyst; SIRS: Systemic inflammatory response syndrome; ACS: Abdominal compartment syndrome; ARDS: Acute respiratory distress syndrome; MODS: Multiple organ dysfunction syndrome; SAP: Severe acute pancreatitis; ICU: Intensive care unit.

Table 3 Association of metabolic syndrome component count with clinical severity scores and hospitalization characteristics in hypertriglyceridemia-acute pancreatitis, n (%)

Characteristic	Number of metabolic syndrome components					P value
Characteristic	1 (n = 6)	2 (n = 61)	3 (n = 102)	4 (n = 69)	5 (n = 17)	P value
Age (years)	35.8 ± 8.8	39.8 ± 9.6	40.9 ± 8.2	39.5 ± 9.9	40.2 ± 8.9	0.545
Sex
Male	5 (2.6)	42 (21.5)	76 (39.0)	57 (29.2)	15 (7.7)	0.290
Female	1 (1.7)	19 (31.7)	26 (43.3)	12 (20.0)	2 (3.3)
Scoring systems
Ranson	0.5 (0, 1)	1 (1, 3)	2 (1, 3)	2 (1, 4)	4 (2, 5)	< 0.001^a
BISAP	0 (0, 0.5)	0 (0, 1)	1 (0, 2)	2 (1, 2)	2 (1, 2.5)	< 0.001^a
MCTSI	4 (2, 6.5)	4 (2, 8)	6 (2, 8)	8 (4, 8)	8 (4, 8)	0.005^a
Length of hospital stays (days)	6 (4.3, 9.8)	8 (5, 12.5)	10 (7, 14.3)	11 (6, 17)	19 (13, 19.5)	0.014^a
Total costs (thousand CNY)	8.6 (5.9, 17.1)	14.0 (6.8, 24.6)	17.9 (11.4, 37.7)	26.1 (14.7, 61.1)	25.8 (16.7, 81.3)	< 0.001^a

^aP < 0.05.

CNY: China yuan; BISAP: Bedside Index of Severity in acute pancreatitis; MCTSI: Modified computed tomography severity index.

Table 4 Relationship between metabolic syndrome and clinical outcomes in hypertriglyceridemia-acute pancreatitis

Outcome parameter	Group
	Non-metabolic syndrome		Low-component metabolic Syndrome		High-component metabolic syndrome
	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value
Pleural effusion	Reference	-	2.16 (1.13-4.14)	0.019^a	3.43 (1.73-6.80)	< 0.001^a
Peritoneal effusion	Reference	-	2.27 (1.04-4.92)	0.039^a	3.78 (1.72-8.34)	0.001^a
Localized complications	Reference	-	2.14 (1.11-4.13)	0.023^a	3.63 (1.73-7.65)	0.001^a
APFC	Reference	-	1.61 (0.73-3.55)	0.240	2.09 (0.94-4.65)	0.071
ANC	Reference	-	0.99 (0.52-1.93)	0.992	1.64 (0.84-3.20)	0.149
PPC	Reference	-	1.10 (0.33-3.62)	0.876	0.72 (0.18-2.89)	0.638
Systemic complications	Reference	-	2.67 (1.38-5.16)	0.004^a	6.49 (3.17-13.30)	< 0.001^a
Respiratory failure	Reference	-	3.24 (1.03-10.16)	0.044^a	9.32 (3.07-28.25)	< 0.001^a
Renal failure	Reference	-	1.54 (0.55-4.30)	0.414	3.02 (1.12-8.11)	0.028^a
Circulatory failure	Reference	-	2.86 (0.56-14.73)	0.207	3.14 (0.60-16.26)	0.173
SIRS	Reference		2.54 (1.30-4.93)	0.006^a	4.54 (2.25-9.14)	< 0.001^a
SAP	Reference	-	1.88 (0.74-4.82)	0.187	5.05 (2.04-12.49)	< 0.001^a
ICU admission	Reference	-	2.25 (0.83-6.13)	0.112	6.41 (2.42-16.97)	< 0.001^a

^aP < 0.05.

OR: Odds ratio; APFC: Acute peripancreatic fluid collection; ANC: Acute necrotic collection; PPC: Pancreatic pseudocyst; SIRS: Systemic inflammatory response syndrome; SAP: Severe acute pancreatitis; ICU: Intensive care unit.

Citation: Fu ZH, Zhao ZY, Liang YB, Cheng DY, Luo JM, Jiang HX, Qin SY. Impact of metabolic syndrome components on clinical outcomes in hypertriglyceridemia-induced acute pancreatitis. World J Gastroenterol 2024; 30(35): 3996-4010
URL: https://www.wjgnet.com/1007-9327/full/v30/i35/3996.htm
DOI: https://dx.doi.org/10.3748/wjg.v30.i35.3996