Triglycerides to high‐density lipoprotein cholesterol (TG/HDL‐C) ratio is an independent predictor of the severity of hyperlipidaemic acute pancreatitis

Background The incidence of acute pancreatitis caused by hyperlipidaemia is increasing. A quick and easy diagnosis of the severity of hyperlipidaemic acute pancreatitis (HTGP) is important to improve patient prognosis and reduce mortality. Previous studies reported that insulin resistance (IR) is associated with acute pancreatitis. Our study aimed to investigate the correlation between the triglycerides to high‐density lipoprotein cholesterol (TG/HDL‐C) ratio and HTGP. Methods Patients' laboratory and clinical parameters were obtained from the institutional pancreatitis database. Univariate and multivariate logistic regression analyses were applied to evaluate the risk factors for the severity of HTGP and the efficacy of four clinical scoring systems: Ranson's Criteria, Acute Physiology and Chronic Health Evaluation II (APACHE II), the Bedside Index for Severity in Acute Pancreatitis (BISAP), and Marshall. Results Of 290 patients, 134 (46.2%) were diagnosed with moderately severe to severe HTGP. The TG/HDL‐C ratio was higher in the moderately severe to severe HTGP subgroup than in the mild HTGP subgroup. Among the independent risk factors, such as amylase, albumin, aspartate transaminase (AST), systemic inflammatory response syndrome (SIRS), and TG/HDL‐C ratio, the TG/HDL‐C ratio had the highest area under the curve (AUC) (0.727, 95% CI, 0.571–0.701). In comparison with other clinical scoring systems, the TG/HDL‐C ratio has a relatively preferable predictive ability. Conclusion Our findings suggest that the TG/HDL‐C ratio is positively correlated with HTGP severity and could be used as a simple indicator of severe HTGP. Insulin resistance affects the severity of hyperlipidaemic acute pancreatitis. Huang and colleagues found that the triglycerides to high‐density lipoprotein cholesterol ratio, a surrogate marker of insulin resistance, predicted the severity of hyperlipidaemic acute pancreatitis in a fast, simple, and dynamically monitorable manner, with similar predictive efficiency as universal clinical scoring systems.