Predictive utility of the triglyceride-glucose index and visceral adiposity-related indices for severe progression in hypertriglyceridemic pancreatitis.

BACKGROUND

In China, hypertriglyceridemic pancreatitis (HTGP) ranks as the second most common cause of acute pancreatitis (AP). It primarily affects younger individuals and is associated with higher risks of disease progression to severity and recurrence. Existing severity-scoring systems are complex, simpler visceral adipose tissue (VAT)-related indices and the triglyceride-glucose (TyG) index show potential but lack research.

OBJECTIVE

The aim of this study is to evaluate the predictive value of the TyG index and VAT-related indices in identifying individuals at risk for severe progression of HTGP.

METHODS

A retrospective study analyzed 343 AP patients from 2018 to 2023, divided into HTGP (n = 197) and non-HTGP (n = 146) groups. Patients were further stratified by disease severity. Baseline characteristics, laboratory results, VAT-related indices, and TyG index were compared between groups. Logistic regression identified risk factors for severe HTGP progression, while receiver operating characteristic curve analysis evaluated the predictive accuracy of individual and combined indices.

RESULTS

The proportion of HTGP cases rose annually, comprising 67% of all AP cases in 2023, with a predominantly male cohort (77.7%) and a median age of 38. The severe progression rate reached 59.4%. Diabetes mellitus and hepatic steatosis were significantly more common in the HTGP group (P < .05). Patients with moderately severe or severe HTGP had higher TyG index, Chinese visceral adiposity index (CVAI), cardiac metabolic index (CMI), lipid accumulation product (LAP), white blood cell (WBC) count, glucose, triglyceride levels, and diabetes prevalence (all P < .05). Multivariate analysis identified WBC count, TyG index, and CVAI as independent predictors of severity. A combined index of these markers yielded an area under curve of 0.811, improving predictive accuracy.

CONCLUSION

HTGP shows increasing incidence and severity. Elevated TyG index, CVAI, and WBC count predict severity, and a combined index improves accuracy in identifying high-risk patients.