Correlation Between Non-alcoholic Fatty Liver Disease And Severity Of Acute Pancreatitis

Objectives Acute pancreatitis(AP)refers to acute inflammatory disease that cause pancreatic self-digestion,damage to pancreatic tissue and dysfunction of glands,distant organs and multisystem due to various etiologies.The mortality rate of serve acute pancreatitis is high,therefore more objective evidences need to be found to provide for predicting AP.The study analyzes the correlation between early non-alcoholic fatty liver disease(NAFLD)and severity of AP,and evaluates the value of nonalcoholic fatty liver disease in predicting AP by combining the diagnosis of nonalcoholic fatty liver disease with BISAP score.Methods A toal of 207 patients with acute pancreatitis who visited our hospital from February 2020 to October 2022 and were selected.According to whether they have NAFLD or not,those patients were divided into fatty liver group and non-fatty liver group.General clinical data(age,sex,BMI,smoking history,and hypertension history and diabetes history),etiology,laboratory tests,length of hospitalization,BISAP score,classification of severity,local and systemic complications were collected,and the differences about above indicators between two groups were compared,multivariate regression analysis were used to find risk factors for moderate to serve acute pancreatitis.The plotting of the receiver operating characteristic curve(ROC)of BISAP score,diagnosis of NAFLD,and diagnosis of NAFLD combined with BISAP score predicting moderate to serve AP.The specificity and sensitivity,and the areas under the ROC curve(AUC)of above three ways in predicting serverity of AP were compared.Results The average age level and albumin level of patients in the fatty liver group were lower than those in the non-fatty liver group,and the difference was statistically significant,and prevelence of diabetes,hyperlipidemia AP ratio,BMI level,white blood cell level,and C reactive protein value,triglyceride level,total cholesterol level,and length of hospital stay were higher than those in the non-fatty liver group.There were no significant differences in sex ratio,smoking history,and prevalence of hypertension between the two groups.The proportion of severe AP and patients complicated respiratory failure,systemic inflammatory syndrome,and infectious pancreatic necrosis in the fatty liver group was higher than that in the non-fatty liver group.With the increase of NAFLD severity,the proportion of moderate severe acute pancreatitis and severe acute pancreatitis increased(χ~2=10.131,P=0.038).The effects of NAFLD,diabetes,elevated BMI,and decreased albumin on moderate to severe AP are significant.The AUC values of NAFLD,BISAP score,and NAFLD combined with BISAP score in predicting moderate to severe AP were 0.712,0.824,and 0.890,respectively,and the sensitivity was respectively 58.7%,77.4%and 85.3%,and the specificity was 77.8%,84.5%and 84.2%,respectively.Conclusions1.AP patients with NAFLD are more likely to develop moderate to severe AP and complicate systemic complications and infected pancreatic necrosis.2.As the severity of NAFLD increases,so does the severity of AP.3.Diabetes,NAFLD,high BMI,and low albumin levels are risk factors affecting moderate to severe AP.4.NAFLD diagnosis combined with BISAP score can improve the ability of BISAP score to predict moderate and severe AP.