The predictive value of TyG index combined with Naples prognostic score for the severity and prognosis of acute pancreatitis

doi:10.11958/20253396

Abstract

Abstract:

Objective To investigate the predictive value of the triglyceride-glucose (TyG) index combination with the Naples prognostic score (NPS) for the severity and prognosis of acute pancreatitis (AP). Methods A retrospective study was conducted involving 227 patients with acute pancreatitis (AP). Patients were categorised according to disease severity into the mild acute pancreatitis (MAP) group (137 patients) and the severe acute pancreatitis (SAP) group (90 patients). Additionally, patients were classified into the favourable prognosis group (169 patients) and the unfavourable prognosis group (58 patients) based on clinical outcome during hospitalisation. Clinical data were compared between groups. Spearman correlation analysis was used to assess the correlation between these factors and disease severity. Multivariate Logistic regression model was employed to analyse their impact on prognosis. The predictive value was evaluated using receiver operating characteristic (ROC) curves. Results Compared with the MAP group, the age, TyG index, proportion of patients with NPS ≥ 2, neutrophil count (NEU), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), amylase (AMY), lipase (LPS), serum creatinine (Scr), blood urea nitrogen (BUN) and total cholesterol (TC) were significantly higher (P<0.05), whilst lymphocyte count (LYM), lymphocyte-to-monocyte ratio (LMR) and albumin (ALB) were significantly lower in the SAP group (P<0.05). TyG index and NPS were positively correlated with the severity of AP (both P<0.001). Multivariate Logistic regression analysis showed that, after adjusting for confounding factors, elevated TyG index (OR = 1.200, 95%CI: 1.036-1.390, P = 0.015) and NPS (OR = 1.418, 95%CI: 1.118-1.797, P = 0.004) were independent factors for poor prognosis. Both TyG index and NPS had predictive value for patients with different severities of AP and for prognosis. Furthermore, their combined predictive value was even higher. Conclusion The combination of the TyG index and NPS has high predictive value for the severity and prognosis of AP, and can serve as a reference for clinical management.

Key words: pancreatitis, prognosis, forecasting, TyG index, Naples prognostic score

CLC Number:

R576.1

Figures/Tables 5

References 20

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组别	n		年龄/岁			性别（男/女）	发病诱因										高血压史			糖尿病史	TyG指数			胰周积液			胸腔积液
组别	n		年龄/岁			性别（男/女）	胆源性			酒精性		高脂血症性			其他		高血压史			糖尿病史	TyG指数			胰周积液			胸腔积液
MAP组	137		45.21±12.66			82/55	11（8.03）			5（3.65）		98（71.53）			23（16.79）		32（23.36）			21（15.33）	8.52±0.63			42（30.66）			5（3.65）
SAP组	90		52.32±13.13			59/31	3（3.33）			3（3.33）		76（84.44）			8（8.89）		29（32.22）			22（24.44）	9.87±0.85			31（34.44）			5（5.56）
t或χ²			4.081^＊＊			0.750	6.425										2.172			2.940	13.723^＊＊			0.357			0.469
组别			腹腔积液		NPS								WBC/ （×10⁹/L）			NEU/ （×10⁹/L）			LYM/ （×10⁹/L）				MONO/ （×10⁹/L）			NLR
组别			腹腔积液		<2分				≥2分				WBC/ （×10⁹/L）			NEU/ （×10⁹/L）			LYM/ （×10⁹/L）				MONO/ （×10⁹/L）			NLR
MAP组			8（5.84）		85（62.04）				52（37.96）				8.22±2.14			8.10±1.81			1.52±0.53				0.42±0.15			5.34±0.98
SAP组			7（7.78）		33（36.67）				57（63.33）				8.72±4.20			9.35±3.73			1.37±0.36				0.47±0.26			6.36±1.92
t或χ²			0.331		14.014^＊＊								1.173			3.357^＊			2.305^＊				1.853			5.279^＊＊
组别		LMR		ALB/（g/L）				TC/（mmol/L）			CRP/（mg/L）			AMY/（U/L）				LPS/（U/L）				Scr/（μmol/L）			BUN/（mmol/L）
MAP组		3.62±1.12		38.56±4.22				5.18±1.23			35.26±12.60			856.01±320.07				125.15±45.29				65.68±25.54			5.29±1.37
SAP组		2.91±0.68		34.63±3.16				5.72±1.82			41.88±18.71			1 052.21±522.37				190.71±59.48				82.67±35.19			6.18±3.61
t		5.411^＊＊		7.552^＊＊				2.663^＊			3.189^＊			3.508^＊＊				9.405^＊＊				4.211^＊＊			2.616^＊

组别	n		年龄/岁			性别（男/女）	发病诱因										高血压史			糖尿病史	TyG指数			胰周积液			胸腔积液
组别	n		年龄/岁			性别（男/女）	胆源性			酒精性		高脂血症性			其他		高血压史			糖尿病史	TyG指数			胰周积液			胸腔积液
MAP组	137		45.21±12.66			82/55	11（8.03）			5（3.65）		98（71.53）			23（16.79）		32（23.36）			21（15.33）	8.52±0.63			42（30.66）			5（3.65）
SAP组	90		52.32±13.13			59/31	3（3.33）			3（3.33）		76（84.44）			8（8.89）		29（32.22）			22（24.44）	9.87±0.85			31（34.44）			5（5.56）
t或χ²			4.081^＊＊			0.750	6.425										2.172			2.940	13.723^＊＊			0.357			0.469
组别			腹腔积液		NPS								WBC/ （×10⁹/L）			NEU/ （×10⁹/L）			LYM/ （×10⁹/L）				MONO/ （×10⁹/L）			NLR
组别			腹腔积液		<2分				≥2分				WBC/ （×10⁹/L）			NEU/ （×10⁹/L）			LYM/ （×10⁹/L）				MONO/ （×10⁹/L）			NLR
MAP组			8（5.84）		85（62.04）				52（37.96）				8.22±2.14			8.10±1.81			1.52±0.53				0.42±0.15			5.34±0.98
SAP组			7（7.78）		33（36.67）				57（63.33）				8.72±4.20			9.35±3.73			1.37±0.36				0.47±0.26			6.36±1.92
t或χ²			0.331		14.014^＊＊								1.173			3.357^＊			2.305^＊				1.853			5.279^＊＊
组别		LMR		ALB/（g/L）				TC/（mmol/L）			CRP/（mg/L）			AMY/（U/L）				LPS/（U/L）				Scr/（μmol/L）			BUN/（mmol/L）
MAP组		3.62±1.12		38.56±4.22				5.18±1.23			35.26±12.60			856.01±320.07				125.15±45.29				65.68±25.54			5.29±1.37
SAP组		2.91±0.68		34.63±3.16				5.72±1.82			41.88±18.71			1 052.21±522.37				190.71±59.48				82.67±35.19			6.18±3.61
t		5.411^＊＊		7.552^＊＊				2.663^＊			3.189^＊			3.508^＊＊				9.405^＊＊				4.211^＊＊			2.616^＊

组别	n	TyG指数	NPS
组别	n	TyG指数	<2分	≥2分
预后良好组	169	8.65±0.62	105（62.13）	64（37.87）
预后不良组	58	10.23±0.75	13（22.41）	45（77.59）
t或χ²		15.842^＊＊	27.288^＊＊

组别	n	TyG指数	NPS
组别	n	TyG指数	<2分	≥2分
预后良好组	169	8.65±0.62	105（62.13）	64（37.87）
预后不良组	58	10.23±0.75	13（22.41）	45（77.59）
t或χ²		15.842^＊＊	27.288^＊＊

项目	β	SE	Wald χ²	P	OR（95%CI）
模型1
TyG指数	0.301	0.062	23.569	<0.001	1.351（1.197~1.526）
NPS	0.462	0.096	23.160	<0.001	1.587（1.315~1.916）
模型2
TyG指数	0.251	0.071	12.498	<0.001	1.285（1.118~1.477）
NPS	0.416	0.102	16.634	<0.001	1.516（1.241~1.851）
模型3
TyG指数	0.182	0.075	5.889	0.015	1.200（1.036~1.390）
NPS	0.349	0.121	8.319	0.004	1.418（1.118~1.797）