The Value Of TyG Index In The Evaluation Of The Severity Of Acute Pancreatitis

Objective Acute pancreatitis（AP）is a common critical disease in clinics.Most patients have a good prognosis,and a small number of patients progress to severe acute pancreatitis（SAP）,with poor prognosis and high mortality.Early prediction of AP severity and early intervention of complications can reduce mortality.The current scoring system for AP severity is characterized by multiple items,time consumption and low predictive efficiency.It remains an urgent clinical need to explore a simple and efficient method for assessing the severity of AP.The purpose of this study was to investigate the predictive value of TyG index（triglyceride-glucose index）in assessing the severity of acute pancreatitis.Methods According to the inclusion and exclusion criteria,the clinical data of 226 patients who were admitted to the Department of Gastroenterology of Yunnan First People’s Hospital from December 2019 to December 2021 and met AP diagnosis were retrospectively gathered,and the TyG ratio of each patient was calculated.SPSS26.0software was used for analysis.They were divided into non-SAP group（including MAP and MSAP）and SAP group according to their severity（The 2012 revision Atlanta）.Binary Logistic regression analysis and object operating characteristic curve were used to investigate the value of TyG alone and in combination with other inflammatory markers in assessing the seriousness of acute pancreatitis.According to etiological classification,the difference and early evaluation value of TyG in hypertriglycerideemic AP group（HTGAP）and biliary AP group（BAP）were compared.Results 1.In severity group: there was no significant difference in basic clinical data（including history of hypertension,history of diabetes,gender and age）between the SAP group and non-SAP group（P>0.05）;there were significant differences in TyG,D-DImer（D-D2）,lactate dehydrogenase（LDH）,C-reactive protein（CRP）and serum calcium between the two groups（P<0.05）.TyG,LDH and D dimer were independent influencing factors of AP,and there were significant differences between the two groups（P<0.05）.The AUC of TyG,LDH and D dimer were 0.791,0.757 and 0.722,respectively.TyG had the highest diagnostic efficiency and the highest sensitivity was88.33%.In the merged forecast,TyG and LDH combined had better diagnostic efficacy than the other two,with an AUC of 0.847 and a sensitivity of 88.33%.When TyG was combined with D-dimer and LDH,AUC was 0.857,sensitivity was 90.00%,specificity was 72.89%.2.In the etiology group: TyG was significantly different in the HTGAP group and BAP group and was an independent prognostic indicator of severity.In the BAP group,the truncation value of TyG predicted SAP was 7.49mg/d L and AUC was0.780.The predicted SAP truncation value of TyG in HTGAP group was 8.53mg/d L and AUC was 0.761.Conclusions TyG can be used as an early indicator to assess the severity of AP,and the value of TyG increases with the aggravation of AP.2.When TyG,LDH and D dimer were combined to predict the severity of AP,the assessment efficiency increased,and when the three indexes were combined,the assessment efficiency was the highest.3.TyG has early predictive evaluation value for the severity of HTGAP and BAP.