Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis

Ramin Niknam,1 Jamshid Moradi,1 Keramat Allah Jahanshahi,2 Laleh Mahmoudi,3 Fardad Ejtehadi1 1Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; 2Faculty of Medical School, Yasuj University of Medical Sciences, Yasuj, Iran; 3Department of Clinical Pharmacy,...

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Main Authors: Niknam R, Moradi J, Jahanshahi KA, Mahmoudi L, Ejtehadi F
Format: Article
Language:English
Published: Dove Medical Press 2020-04-01
Series:Diabetes, Metabolic Syndrome and Obesity
Subjects:
Online Access:https://www.dovepress.com/association-between-metabolic-syndrome-and-its-components-with-severit-peer-reviewed-article-DMSO
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author Niknam R
Moradi J
Jahanshahi KA
Mahmoudi L
Ejtehadi F
author_facet Niknam R
Moradi J
Jahanshahi KA
Mahmoudi L
Ejtehadi F
author_sort Niknam R
collection DOAJ
description Ramin Niknam,1 Jamshid Moradi,1 Keramat Allah Jahanshahi,2 Laleh Mahmoudi,3 Fardad Ejtehadi1 1Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; 2Faculty of Medical School, Yasuj University of Medical Sciences, Yasuj, Iran; 3Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IranCorrespondence: Fardad EjtehadiGastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IranTel +98 917 113 4391Fax +98 713 628 1442Email edjtehadif@sums.ac.irBackground: Acute pancreatitis (AP) and metabolic syndrome (MetS) are common clinical problems with serious complications and high cost of treatment. The relationship between MetS and severity of AP is unknown, and because there are very few published articles, further studies had been recommended. Therefore, we designed this study to estimate the association between MetS and its components with AP severity.Patients and Methods: In this prospective analytical cross-sectional study, all AP patients who referred to two referral hospitals affiliated with Shiraz University of Medical Sciences between 2016 and 2019 were evaluated. The diagnosis of MetS syndrome as well as follow-up of patients for evaluation of severity and outcome of AP was performed in all enrolled patients. National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III) was used for diagnosis of MetS. Bedside Index for Severity in Acute Pancreatitis (BISAP) and revised Atlanta classification (RAC) were used to estimate the severity of AP. Finally, the association between MetS syndrome and its components at different AP severities was compared.Results: Of the 214 patients referred to our center, a total of 76 patients with AP were included in this study. Of the included patients,  40 (52.6%) were male and 36 (47.4%) were female. Frequency of patients in Mets and non-MetS groups was 34 (44.74%) and 42 (55.26%), respectively. The gender and mean age difference between Mets and non-MetS groups were not statistically significant. According to Mets groups,  25 (73.5%) and 9 (26.5%) AP patients with MetS had BISAP score of 0– 2 and 3– 5, respectively. BISAP score in MetS group was significantly higher than non-MetS group (P = 0.022). Overall,  20 (58.8%), 11 (32.4%), and 3 (8.8%) of AP patients with MetS had mild, moderately severe, and severe AP based on RAC, respectively. Severe RAC was significantly higher in the MetS group than in the non-MetS group (P = 0.029). The frequency of complications in MetS group was significantly higher than in non-MetS group (P= 0.008). The length of hospital stay was also significantly higher in the MetS group than in the non-MetS group (P = 0.001). Overall, three patients died, two of whom had MetS and all had severe RAC and BISAP 3– 5. Waist circumference, fasting blood sugar, and triglyceride were significantly higher in the severe and moderately severe types of AP group than in the mild AP group, according to RAC. Although, mean of all components of MetS except HDL-cholesterol were higher in BISAP of 3– 5 group than BISAP of 0– 2 group, the difference was only significant in waist circumference.Conclusion: The present study showed that there was a significant association between the rate of MetS and its components including waist circumference, hyperglycemia and hypertriglyceridemia with increasing AP severity. This study showed that the incidence of more severe AP in patients with MetS is much higher than in patients without MetS. We recommend that the new studies with larger sample sizes are conducted with careful consideration of confounding factors to investigate the relationship between the severity of MetS and AP as well as the effect of MetS treatment on the nature of AP.Keywords: acute pancreatitis, metabolic syndrome, Bedside Index of Severity in Acute Pancreatitis, BISAP, revised Atlanta classification, severity
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spelling doaj.art-663c1c2d4e794eed95e931deacb4677a2023-02-02T09:54:04ZengDove Medical PressDiabetes, Metabolic Syndrome and Obesity1178-70072020-04-01Volume 131289129653295Association Between Metabolic Syndrome and Its Components with Severity of Acute PancreatitisNiknam RMoradi JJahanshahi KAMahmoudi LEjtehadi FRamin Niknam,1 Jamshid Moradi,1 Keramat Allah Jahanshahi,2 Laleh Mahmoudi,3 Fardad Ejtehadi1 1Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; 2Faculty of Medical School, Yasuj University of Medical Sciences, Yasuj, Iran; 3Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IranCorrespondence: Fardad EjtehadiGastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IranTel +98 917 113 4391Fax +98 713 628 1442Email edjtehadif@sums.ac.irBackground: Acute pancreatitis (AP) and metabolic syndrome (MetS) are common clinical problems with serious complications and high cost of treatment. The relationship between MetS and severity of AP is unknown, and because there are very few published articles, further studies had been recommended. Therefore, we designed this study to estimate the association between MetS and its components with AP severity.Patients and Methods: In this prospective analytical cross-sectional study, all AP patients who referred to two referral hospitals affiliated with Shiraz University of Medical Sciences between 2016 and 2019 were evaluated. The diagnosis of MetS syndrome as well as follow-up of patients for evaluation of severity and outcome of AP was performed in all enrolled patients. National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III) was used for diagnosis of MetS. Bedside Index for Severity in Acute Pancreatitis (BISAP) and revised Atlanta classification (RAC) were used to estimate the severity of AP. Finally, the association between MetS syndrome and its components at different AP severities was compared.Results: Of the 214 patients referred to our center, a total of 76 patients with AP were included in this study. Of the included patients,  40 (52.6%) were male and 36 (47.4%) were female. Frequency of patients in Mets and non-MetS groups was 34 (44.74%) and 42 (55.26%), respectively. The gender and mean age difference between Mets and non-MetS groups were not statistically significant. According to Mets groups,  25 (73.5%) and 9 (26.5%) AP patients with MetS had BISAP score of 0– 2 and 3– 5, respectively. BISAP score in MetS group was significantly higher than non-MetS group (P = 0.022). Overall,  20 (58.8%), 11 (32.4%), and 3 (8.8%) of AP patients with MetS had mild, moderately severe, and severe AP based on RAC, respectively. Severe RAC was significantly higher in the MetS group than in the non-MetS group (P = 0.029). The frequency of complications in MetS group was significantly higher than in non-MetS group (P= 0.008). The length of hospital stay was also significantly higher in the MetS group than in the non-MetS group (P = 0.001). Overall, three patients died, two of whom had MetS and all had severe RAC and BISAP 3– 5. Waist circumference, fasting blood sugar, and triglyceride were significantly higher in the severe and moderately severe types of AP group than in the mild AP group, according to RAC. Although, mean of all components of MetS except HDL-cholesterol were higher in BISAP of 3– 5 group than BISAP of 0– 2 group, the difference was only significant in waist circumference.Conclusion: The present study showed that there was a significant association between the rate of MetS and its components including waist circumference, hyperglycemia and hypertriglyceridemia with increasing AP severity. This study showed that the incidence of more severe AP in patients with MetS is much higher than in patients without MetS. We recommend that the new studies with larger sample sizes are conducted with careful consideration of confounding factors to investigate the relationship between the severity of MetS and AP as well as the effect of MetS treatment on the nature of AP.Keywords: acute pancreatitis, metabolic syndrome, Bedside Index of Severity in Acute Pancreatitis, BISAP, revised Atlanta classification, severityhttps://www.dovepress.com/association-between-metabolic-syndrome-and-its-components-with-severit-peer-reviewed-article-DMSOacute pancreatitismetabolic syndromebedside index of severity in acute pancreatitis (bisap)revised atlanta classificationseverity
spellingShingle Niknam R
Moradi J
Jahanshahi KA
Mahmoudi L
Ejtehadi F
Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis
Diabetes, Metabolic Syndrome and Obesity
acute pancreatitis
metabolic syndrome
bedside index of severity in acute pancreatitis (bisap)
revised atlanta classification
severity
title Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis
title_full Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis
title_fullStr Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis
title_full_unstemmed Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis
title_short Association Between Metabolic Syndrome and Its Components with Severity of Acute Pancreatitis
title_sort association between metabolic syndrome and its components with severity of acute pancreatitis
topic acute pancreatitis
metabolic syndrome
bedside index of severity in acute pancreatitis (bisap)
revised atlanta classification
severity
url https://www.dovepress.com/association-between-metabolic-syndrome-and-its-components-with-severit-peer-reviewed-article-DMSO
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