The Clinical Relation Between Nonalcoholic Fatty Pancreas Disease And The Severity Of Acute Pancreatitis

Background:Nonalcoholic fatty pancreas disease(NAFPD),which is closely related to obesity and metabolic syndrome,has attracted the attention of researchers with the number of obesity and metabolic syndrome patients increasing rapidly.NAFPD is a common disease that often be overlooked by clinicians.Researches have shown that NAFPD is closely related to metabolic syndrome,diabetes,acute and chronic pancreatitis,pancreatic cancer.Acute pancreatitis(AP)is a common gastrointestinal disease,severe pancreatitis with organ failure may reach to poor prognosis.The aim of this study was to investigate the relationship between NAFPD and the severity of acute pancreatitis.Methods:Patients with acute pancreatitis who were hospitalized at the First Affiliated Hospital,College of Medicine,Zhejiang University from January 1,2014 to December 1,2016 were enrolled in this study.Abdominal Computed tomography(CT)should be examined within 48 hours after admission.Meanwhile,abdominal CT,which is used for measuring the pancreatic CT attenuation and the splenic CT attenuation,should be performed one year prior to the onset of AP.Visceral adipose tissue(VAT)and body mass index(BMI)are also measured.The ranson ’s score,APACHE Ⅱ(acute physiology and chronic health score Ⅱ)score,MCTSI(corrected CT severity index)score is calculated to evaluate the severity of AP.The difference and ratio of the pancreatic CT attenuation and the splenic CT attenuation(P-S、P/S)were compared with the above scores.Results:There are 17 males(56.7%)and 13 females(43.3%)with an average age of 57.73 ± 16.6 years.There are 12(40%)severe acute pancreatitis(SAP)patients and 18(60%)mild pancreatitis in total.The mean pancreatic CT attenuation,P-S and P/S in patients with severe pancreatitis are significantly lower than those in patients with mild pancreatitis.The mean P-S and P/S are significantly correlated with Ranson’s score,APACHE II score and MCTSI score.The ratio of severe pancreatitis in the NAFPD group was significantly higher than that in the normal group.The VAT in Patients with severe pancreatitis is significantly higher than patients with mild pancreatitis.BMI has no significant difference between severe pancreatitis patients and mild pancreatitis patients.Conclusion:NAFPD is associated with the severity of AP,and P-S and P/S are correlated with the severity of AP.Visceral adipose tissue is associated with the severity of AP.NAFPD and high VAT are more likely to develop severe pancreatitis,so both have an important role in the early assessment of the prognosis of acute pancreatitis.