| Background and PurposeIn recent years,the incidence of acute pancreatitis has increased.Many studies have shown that obesity can aggravate the severity of acute pancreatitis and a large number of studies have also shown that obesity plays an important role in increasing the severity of disease,such as cardiovascular disease and metabolic diseases,and the risk of death.Studies have evaluated the use of the waist-to-height ratio to predict the severity of some diseases,but no such studies on acute pancreatitis have been conducted.The purpose of this study was to simply evaluate the severity of acute pancreatitis by the waist-to-height ratio.Methods1.Participants:We accepted patients with AP who were hospitalized in the Department of Gastroenterology of the First Affiliated Hospital of Nanchang University from May 2019 to December 2019 in this observational study.2.Data collection : We measured the height,weight,waistline and collected other clinical data of the patients included.3.Statistical methods: The statistical analysis was performed using SPSS20.0 statistical software.Quantitative data are presented as the meanąSD,and the statistical significance was verified by one-way analysis of variance or Student's t test.Categorical data were showed as numbers(percentage of the group)and were analyzed by Pearson's chi-square test.And independent risk factor analysis using multivariate logistic regression.Results1.General data:A total of 258 patients were included in the study.Among these patients,77 were mild acute pancreatitis(29.8%),120 were moderately severe acute pancreatitis(46.5%)and 61 were severe acute pancreatitis(23.6%).And it includes 174 male patients,accounting for 67.4%.Theaverage age of the patients was 50.88ą14.92 years.The etiology of AP included biliary pancreatitis 125 cases(48.5%),hyperlipidemic pancreatitis76 cases(29.5%),idiopathic pancreatitis 17 cases(6.6%),and alcoholic pancreatitis 18 cases(7.0%),and other causes included 21 cases of mixed pancreatitis(8.1%)and 1 case of drug-related AP(0.4%).There were 199cases(77.1%)of patients diagnosed with acute pancreas for the first time.2.Comparison of anthropometric indexes in patients with different AP severities.The waist-to-height ratio was significantly higher than other indexes in moderate severe and severe patients(P<0.05).When the cut-off of the waist-to-height ratio was 0.538,waist-to-height ratio showed the highest area under the curve(AUC)of the receiver operating characteristic curve(AUC 0.696;95% confidence interval [CI]: 0.628-0.763)for predicting moderately severe or severe acute pancreatitis.And the threshold was 71.82%sensitive and 57.14% specific for predicting moderately severe and severe acute pancreatitis.The threshold for predicting the best waist-to-height ratio in severe acute pancreatitis patients was 0.567.The AUC of this threshold is0.795(95% CI: 0.734-0.855)for predicting severe acute pancreatitis,with a sensitivity of 82.5% and specificity of 68.2%.3.We conducted multivariate logistic regression analysis in severe acute pancreatitis.Finally,albumin< 35g/L(OR:3.557,95%CI:1.222-10.359),APACHE II score?10(OR:7.793,95%CI:2.288-26.543),respiration rate>20beats per minute(OR:13.765;95%CI:4.580-41.369),first-time AP(OR:13.017;95% CI: 2.420-70.013)and waist-to-height ratio?0.567(OR: 11.565;95%CI: 3.905-34.245)were found to be independent risk factors of severe acute pancreatitis.Conclusions1.Waist-to-height ratio is closely related to the severity of acute pancreatitis.2.Patients with a WHtR?0.538 are more likely to develop moderately severe or severe acute pancreatitis.What's more,WHtR ? 0.567 is the best threshold for predicting SAP.The tendency of patients with a WHtR ? 0.567 to be diagnosed with SAP was higher than that of patients with a WHtR <0.567.Through this simple evaluation,we can effectively predict SAP early and perform early intervention to improve the prognosis of patients.3.Waist-to-height ratio is an independent risk factor for severe acute pancreatitis. |
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