Clinical Significance of Low-Density Granulocytes in Acute Pancreatitis.

Background

Low-density granulocytes (LDGs), a unique subset of neutrophils, have been shown in previous studies to exhibit distinct biological functions in immune-inflammatory diseases. However, their role in acute pancreatitis (AP) remains unclear.

Objective

To investigate the association between peripheral blood LDGs levels and clinical severity in patients with AP.

Methods

This cross-sectional study analyzed peripheral LDGs levels in 41 mild AP (MAP) patients, 40 moderate-to-severe AP (SAP) patients, and 41 healthy controls (HC). LDGs were measured within 24 h of admission. Statistical analysis, including Kruskal-Wallis tests and logistic regression, assessed LDGs' association with clinical characteristics and AP severity.

Results

LDGs levels were significantly higher in moderate-to-SAP compared to MAP and HC (p < 0.001). Elevated LDGs levels correlated positively with white blood cell count (WBC), glucose (GLU), neutrophil-to-lymphocyte ratio, Acute Physiology and Chronic Health Evaluation II (APACHE II), and Bedside Index for Severity in Acute Pancreatitis (BISAP) scores (p < 0.05). Logistic regression identified LDGs as an independent risk factor for moderate-to-SAP. Receiver operating characteristic (ROC) analysis revealed high predictive accuracy, the area under the curve (AUC = 0.967) at a 2.96% cutoff, with 95.0% sensitivity and 90.2% specificity. The follow-up indicated that patients with LDGs > 2.96% had a higher risk of recurrence.

Conclusion

Elevated peripheral LDGs levels in AP patients are associated with disease activity.