Novel anthropometric indicators of visceral obesity predict the severity of hyperlipidemic acute pancreatitis

Abstract

Background: Obesity substantially contributes to the onset of acute pancreatitis (AP) and influences its progression to severe AP. Although body mass index (BMI) is a widely used anthropometric parameter, it fails to delineate the distribution pattern of adipose tissue. To circumvent this shortcoming, the predictive efficacies of novel anthropometric indicators of visceral obesity, such as lipid accumulation products (LAP), cardiometabolic index (CMI), body roundness index (BRI), visceral adiposity index (VAI), A Body Shape Index (ABSI), and Chinese visceral adiposity index (CVAI) were examined to assess the severity of AP.

Method: The body parameters and laboratory indices of 283 patients with hyperlipidemic acute pancreatitis (HLAP) were retrospectively analysed, and the six novel anthropometric indicators of visceral obesity were calculated. The severity of HLAP was determined using the revised Atlanta classification. The correlation between the six indicators and HLAP severity was evaluated, and the predictive efficacy of the indicators was assessed using area under the curve (AUC). The differences in diagnostic values of the six indicators were also compared using the DeLong test.

Results: Patients with moderate to severe AP had higher VAI, CMI, and LAP than patients with mild AP (all P < 0.001). The highest AUC in predicting HLAP severity was observed for VAI, with a value of 0.733 and 95% confidence interval of 0.678-0.784.

Conclusions: This study demonstrated significant correlations between HLAP severity and VAI, CMI, and LAP indicators. These indicators, particularly VAI, which displayed the highest predictive power, were instrumental in forecasting and evaluating the severity of HLAP.

Fig. 1

Correlation of laboratory tests with severity of HLAP. Abbreviations: ALT, alanine aminotransferase; BUN, blood urea nitrogen; MAP, mild acute pancreatitis, MSAP, moderately severe acute pancreatitis; SAP, severe acute pancreatitis; TBIL, total bilirubin

Fig. 2

Correlation heatmap between anthropometric indicators of visceral obesity. Abbreviations: ABSI: a body shape index; BRI: body roundness index; CMI: cardiometabolic index; CVAI: Chinese visceral adiposity index; LAP: lipid accumulation products; TG: triglyceride; VAI: visceral adiposity index; WC: waist circumference

Fig. 3

Correlation analysis between VAI, CMI, and CAP. Abbreviations: CMI: cardiometabolic index; LAP: lipid accumulation products; VAI: visceral adiposity index

Fig. 4

ROC curve of novel anthropometric indicators and international rating scales. Abbreviations: CMI: cardiometabolic index; LAP: lipid accumulation products; ROC: receiver operating characteristic; VAI: visceral adiposity index