Characteristic Analysis Between Metabolic Abnormalities And Acute Pancreatitis In The Middle-aged And Elderly Population

Purpose: Our research object is the middle-aged and elder population who has acute pancreatitis(AP)with metabolic syndrome(MS)or its factors and/or related chronic metabolic diseases.The aim is to study the key link and clinical characteristics between AP and high-risk factors of MS in the middle-aged and elder population,in order to reduce the incidence of AP,the recurrence rate and seek for controllable factors.Methods: 482 cases of middle-aged and elder patients with AP as the research objects were from many departments(such as Departments of Emergency,Digestive Disease,General Surgery and Intensive Care Unit,etc.)of Tangdu Hospital,Baqiao District in Xi'an of Shaanxi Province during February,2011-February,2016.MS was diagnosed according to the criteria recommended by Chinese Diabetes Society in 2014.Logistic multivariate regression analysis was used for analyzing the relationship between MS and AP.Taken acute biliary pancreatitis and special AP as examples,the relationship between every component of MS with relative risk degree of AP was analyzed with different models using the ROC curve and nomogram.Results: The prevalence of MS in all patients in our study was 12.0%,and people aged with 32-58 years old have a higher occurrence in the crowd.Compared with Non-metabolic syndrome(NMS)patients,there were higher occurrences of obesity(41.4%),2-type diabetes mellitus(T2DM,65.5%)and hypertension(46.6%)in patients with MS.Moreover,79.3% of patients with MS were diagnosed with fatty liver,13.8% with gallstone,8.6% with cholestasis/muddy gallstone,and 32.8% with hypertriglyceridemia,all of which were higher than those in patients with NMS.The result about the logistmultivariate regression,after adjusting some factors including fatty liver,gallstone,recurrent times,gallbladder resection and smoking index,showed that the relative risk ratio(RR)of biliary AP in patients with MS was 0.23(95% confidence interval(CI): 0.04,1.21),while RR of non-biliary AP was was3.07(95% CI: 1.18,7.96).Many components in MS of non-biliary AP,such as obesity,pre-obesity,hypertriglyceridemia,hypertension,T2 DM and fatty liver,were associated with the occurring risk of AP,and their RRs were respectively was 1.81(95%CI: 1.00,3.29)?3.26(95%CI: 0.86,12.40)?1.65(95%CI: 0.65,4.20)?1.50(95%CI: 0.65,3.50)?2.67(95%CI: 1.38,5.17)and 2.43(95%CI: 1.25,4.74).Patients with MS suffering AP had some characteristics,such as early onset,accompanyinghyperglycemia,fatty liver and T2 DM.Conclusion: This study retrospectively analyzed the clinical characteristics of MS and its high-risk components,chronic metabolic disorders and AP in the middle-aged and elder patients,and demonstrated that obesity,T2 DM,fatty liver,cholelithiasis,NAFPD and age 32-58 years-old play the key roles in AP noninfectious inflammatory response.The role of joint MS and its high-risk components is not beyond the role of independent gallstones and TG more than 11.3mmol/Lin inducing AP.