Association of triglyceride-glucose index with disease severity in acute pancreatitis and its prognostic role: A prospective observational study.

Abstract

Background: Acute pancreatitis (AP) is a common gastrointestinal emergency with variable clinical course. Early identification of severe AP (SAP) is crucial for optimizing patient management. The triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, has been implicated in various metabolic disorders, but its role in predicting AP severity remains underexplored.

Methods: In this single-center, prospective study, 138 patients diagnosed with AP were enrolled between January 2022 and December 2024. The severity of AP was classified as per the Revised Atlanta Classification. TyG index was calculated at admission and compared with established severity scores, including the computed tomography severity index (CTSI) and bedside index of severe acute pancreatitis (BISAP). Statistical analyses were performed to assess the correlation of TyG index with disease severity, hospital stay, intensive care unit (ICU) admission and mortality.

Results: Among the enrolled patients, 17% developed SAP. The mean TyG index was significantly higher in the SAP group compared to the non-SAP group (5.01 ± 0.33 vs. 4.69 ± 0.22, p < 0.001). Higher TyG index values correlated with prolonged hospital stay (p = 0.009), increased ICU admissions (p < 0.001) and greater mortality (p = 0.004). The predictive accuracy of the TyG index for SAP, as assessed by the area under the curve (AUC), was 0.902, higher than BISAP 0.696 and CTSI 0.751.

Conclusion: The TyG index is a simple and accessible biomarker that correlates with AP severity and prognosis. Its predictive value is higher than BISAP and CTSI.