Triglyceride and glucose index as a predictor of Acute Pancreatitis

Document Type : Original Article

Authors

1 Lecture of Hepatology, Gastroenterology and Infectious diseases. Beni-Suef University, Egypt

2 Assisted lecture of Hepatology, Gastroenterology and Infectious diseases, Beni-Suef University, Faculty of Medicine, Beni-Suef, Egypt,

3 Lecture of hepatology, gastroenterology and Infectious diseases. Beni-Suef University, Egypt

10.21608/ejmr.2024.277496.1590

Abstract

Early detection of severe acute pancreatitis (AP) is an urgent need to reduce complications and early mortality, and helps in early selection of patients for proper interventions. Aim of study:   to assess the value of TyG index as a severity  predictor of acute pancreatitis. Methods: The study was done on 54 patients who were admitted to hepatology, gastroenterology and Infectious diseases department, Beni-suef University hospital with acute pancreatitis. The collected data of patients within 24 hours of admission were: gender, age, CBC, aspartate aminotransferase, alanine aminotransferase, total bilirubin, albumin, BUN, creatinine, lipase, amylase, CRP, total calcium, ABGs, fasting plasma glucose level, cholesterol, and triglyceride, imaging with abdominal US and chest X-ray. The TyG index and Albumin corrected calcium level were calculated and  were used in evaluated as a risk predictors of acute Pancreatitis. Results: 32 males and 22 females, were divided according to BIS- AP score into two groups: (group 1) 47 patients with mild acute pancreatitis and (group2)7 patients with moderate to severe acute pancreatitis. The TyG index, fasting Blood glucose, BUN, CRP, potassium, white blood cells, calcium and Albumin corrected calcium level showed statically significant differences between two groups. TyG index at cut off (4.94) showed high AUC (0.827), sensitivity (71.4%) and specificity (85.1%), with statically significant differences between . Conclusion: TyG index showed to be promising predictor  of severe acute pancreatitis

Keywords

Main Subjects

References

  1. Papachristou GI, Clermont G, Sharma A, Yadav D, Whitcomb DC.et al. 2007: Risk and markers of severe acute pancreatitis. Gastroenterology clinics of North America.;36(2):277-96, viii.
  2. Swaroop VS, Chari ST, Clain JE.et al 2004: Severe acute pancreatitis. JAMA : the journal of the American Medical Association.;291(23):2865-8.
  3. Robert JH, Frossard JL, Mermillod B, Soravia C, Mensi N, Roth M, et al. 2002;Early prediction of acute pancreatitis: prospective study comparing computed tomography scans, Ranson, Glascow, Acute Physiology and Chronic Health Evaluation II scores, and various serum markers. World journal of surgery. 26(5):612-9.
  4. Ahmed A. 2016;Hypocalcaemia in acute pancreatitis revisited. Indian J Critical Care Med. 20(3):173-7.
  5. Sava L, Pillai S, More U, Sontakke A.et al 2005: Serum calcium measurement total versus free (ionized) calcium Indian J Clin Biochem.;20:(2):158-61.
  6. Lee Y-H and Pratley RE, et al. 2005: The evolving role of inflammation in obesity and the metabolic syndrome. Curr Diabetes Rep;5:70e5.
  7.  Simental-Mendía LE, Rodríguez-Mor_an M, Guerrero-Romero F. et al. 2008;The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 6:299e304.
  8. Pednekar JL, Patil S, Pednekar S.et al. 2015;Bedside index of severity in acute pancreatitis (BISAP) score for predicting prognosis in acute pancreatitis. IAIM 2(2):62-70.
  9. Gutiérrez-Jiménez AA. Castro W. Lagunes R.et al 2014;Total serum calcium and corrected calcium as severity predictors in acute pancreatitis. Revista de Gastroenterologia de Mexico. 79:13-21
  10. Wu BU, Johannes RS, Sun X, et al. 2008;The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 57: 1698Y1703.
  11. Bollen TL, Besselink MG, van Santvoort HC, Gooszen HG, van Leeuwen MS.et al.  2007;Toward an update of the Atlanta classification on acute pancreatitis: review of new and abandoned terms. Pancreas 35(2):107–113.
  12. Vege SS and Chari ST. 2005;Organ failure as an indicator of severity of acute pancreatitis: time to revisit the Atlanta classification. Gastroenterology 128(4):1133–1135.
  13. Peery AF, Dellon ES, Lund J, Crockett SD,McGowan CE, Bulsiewicz WJ, et al. 2012: Burden of gastrointestinal disease in the United States: update. Gastroenterology. 2012;143(5):1179-87 e1-3.
  14. Fisher JM and Gardner TB. 2012;The "golden hours" of management in acute pancreatitis. The American journal of gastroenterology. 107(8):1146-50.
  15. Windsor JA. 2000; Search for prognostic markers for acute pancreatitis. Lancet. 355(9219):1924-5.
  16. Edakkepuram U, Navas MNK, Sasi M, Parambil, Matad S.et al. 2017;Total serum calcium and corrected calcium as severity predictors in acute pancreatitis:a prospective study in a tertiary hospital in South India, Int Surg J. 4(2):560-3.
  17. Gutierrez-Jimenez AA, Castro-Jimenez E, Lagunes- Cordoba R.et al. 2014; [Total serum calcium and corrected calcium as severity predictors in acute pancreatitis]. Revista de gastroenterologia de Mexico. 79(1):13-21.
  18. Nawaz H, Koutroumpakis E, Easler J, Slivka A, Whitcomb DC, Singh VP, et al. 2015; Elevated serum triglycerides are independently associated with persistent organ failure in acute pancreatitis. Am J Gastroenterol 110:1497e503.
  19. Mentula P, Kylanpaa ML, Kemppainen E, Puolakkainen P.et al. 2008:Obesity correlates with early hyperglycemia in patients with acute pancreatitis who developed organ failure. Pancreas;36:e21e5.
  20. Jin Myung Park a, Suk Pyo Shin b, Seung Kook Cho c, Jun Hyeok Lee d, Jae Woo Kim c, Chang Don Kang a, Ji Hye Huh e, Kyong Joo Lee c,et al. * 2020:.Triglyceride and glucose (TyG) index is an effective biomarker to identify severe acute pancreatitis Pancreatology, 09.018
  21. Wu DC, Zhang M, Xu SX, Wu KY, Wang NZ, Wang YZ, et al. 2019;(Nonalcoholic fatty liver disease aggravated the severity of acute pancreatitis in patients. BioMed Res Int 1):9583790.
  22. Vege SS, Gardner TB, Chari ST, Munukuti P, Pearson RK, Clain JE, et al. 2009: Low mortality and high morbidity in severe acute pancreatitis without organ failure: a case for revising the atlanta classification to include “moderately severe acute pancreatitis”. Am J Gastroenterol;104:710e5.
  23. Remes-Troche JM, Duarte-Rojo A, Morales G Robles-Diaz G.et al, 2005; Hemoconcentration is a poor predictor of severity in acute pancreatitis. World journal of gastroenterology : WJG. 11(44):7018-23.
  24. Wu BU, Johannes RS, Sun X, Conwell DL, Banks PA.et al. 2009;. Early changes in blood urea nitrogen predict mortality in acute pancreatitis. Gastroenterology. 137(1):129-35
  25. Wilson C, Heads A, Shenkin A, Imrie CW.et al. 1989;Creactive protein, antiproteases and complement factors as objective markers of severity in acute pancreatitis. The British journal of surgery. 76(2):177-81.
  26. Pezzilli R, Billi P, Miglioli. Et al. 1993: Serum amylase and lipase concentrations and lipase/amylase ratio in assessment of etiology and severity of acute pancreatitis. Dig Dis Sci.;38(7):1265-9.
  27. Lankisch PG, Burchard-Reckert S, Lehnick D.et al. 1999: Underestimation of acute pancreatitis:patients with only a small increase in amylase/lipase levels can also have or develop severe acute pancreatitis. Gut.;44:542-4.
  28. Meher S, Mishra TS, Sasmal PK, Rath S, Sharma R, Rout B, et al 2015: Role of Biomarkers in Diagnosis and Prognostic Evaluation Acute Pancreatitis. J Biomarkers,doi:10.1155/519534.
  29. Manes G, Rabitti PG, Laccetti M, Pacelli L, Carraturo I, Uomo G.et al  1995:Early prediction of aetiology and severity of acute pancreatitis by serum amylase and lipase assays. Minerva gastroenterologica e dietologica.;41(3):211-5.
  30. Moe SM 2008;. Disorders Involving Calcium, Phosphorus, and Magnesium. Prim Care. 35(2):215.
  31. Maher MM and  Dessouky BAM. 2010;Simplified early predictors of severe acute pancreatitis: a prospective study. Gastroenterology Research. 3(1):25-31.
  32. Blum T, Maisonneuve P, Lowenfels AB, Lankisch PG.et al. 2001:Fatal outcome in acute pancreatitis: its occurrence and early prediction. Pancreatology : official journal of the International Association of Pancreatology.;1(3):237-41.
  33. Maringhini A, Ciambra M, Patti R, Randazzo MA, Dardanoni G, Mancuso L, et al. 1996: Ascites, pleural, and pericardial effusions in acute pancreatitis. A prospective study of incidence, natural history, and prognostic role. Dig Dis Sci; 41:848-52.
  34. Vishal Sharma1, Thingbaijam Shanti Devi1, Ravi Sharma1, Puneet Chhabra1, Rajesh Gupta2,Surinder S. Rana1,* and Deepak K. Bhasin, et al. (2014): Arterial pH, bicarbonate levels and base deficit at presentation as markers of predicting mortality in acute pancreatitis: a single-centre prospective study, Gastroenterology Report 1–6.

Files

Share

How to cite

Statistics