A prognostic model based on integrated clinical indicators for recurrent acute pancreatitis in patients with hypertriglyceridemia: a retrospective cohort study.
{"title":"A prognostic model based on integrated clinical indicators for recurrent acute pancreatitis in patients with hypertriglyceridemia: a retrospective cohort study.","authors":"Junyan An, Gaoyuan Zhang, Xinling Zhou","doi":"10.1186/s12944-026-02995-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Recurrence after a first episode of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) remains common, whereas admission-time prediction models are still limited. We aimed to identify independent predictors of 3-year recurrence and develop a practical nomogram for early risk assessment.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive patients with first-episode HTG-AP admitted between January 2019 and January 2023. Clinical variables, laboratory indices obtained within 24 h of admission, and CT-derived skeletal muscle density (SMD) were collected. All patients had at least 3 years of potential follow-up. Candidate variables were screened using least absolute shrinkage and selection operator regression, followed by multivariable logistic regression to identify independent predictors of recurrence. A nomogram was constructed and evaluated by receiver operating characteristic (ROC) analysis, calibration, bootstrap validation, and decision curve analysis (DCA). Sensitivity analyses included ln(CRP + 1) adjustment and Fine-Gray regression.</p><p><strong>Results: </strong>A total of 278 patients were included in the primary logistic regression cohort, of whom 82 (29.5%) developed recurrence within 3 years. Higher triglyceride-glucose (TyG) index (OR 5.027, 95% CI 2.599-9.723, P < 0.001) and smoking history (OR 2.358, 95% CI 1.149-4.838, P = 0.019) were independent risk factors, whereas higher SMD (OR 0.868, 95% CI 0.821-0.917, P < 0.001) and albumin (OR 0.866, 95% CI 0.801-0.936, P < 0.001) were protective factors. The nomogram showed good discrimination, with an AUC of 0.896, and remained stable after bootstrap validation (AUC 0.891). Calibration, DCA, CRP-adjusted analysis, and Fine-Gray regression supported model performance and robustness.</p><p><strong>Conclusions: </strong>A nomogram integrating TyG, SMD, albumin, and smoking history showed good performance for predicting 3-year recurrence after first-episode HTG-AP and may support early risk stratification and individualized follow-up.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":" ","pages":""},"PeriodicalIF":6.9000,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459163/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lipids in Health and Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12944-026-02995-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Recurrence after a first episode of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) remains common, whereas admission-time prediction models are still limited. We aimed to identify independent predictors of 3-year recurrence and develop a practical nomogram for early risk assessment.
Methods: We retrospectively analyzed consecutive patients with first-episode HTG-AP admitted between January 2019 and January 2023. Clinical variables, laboratory indices obtained within 24 h of admission, and CT-derived skeletal muscle density (SMD) were collected. All patients had at least 3 years of potential follow-up. Candidate variables were screened using least absolute shrinkage and selection operator regression, followed by multivariable logistic regression to identify independent predictors of recurrence. A nomogram was constructed and evaluated by receiver operating characteristic (ROC) analysis, calibration, bootstrap validation, and decision curve analysis (DCA). Sensitivity analyses included ln(CRP + 1) adjustment and Fine-Gray regression.
Results: A total of 278 patients were included in the primary logistic regression cohort, of whom 82 (29.5%) developed recurrence within 3 years. Higher triglyceride-glucose (TyG) index (OR 5.027, 95% CI 2.599-9.723, P < 0.001) and smoking history (OR 2.358, 95% CI 1.149-4.838, P = 0.019) were independent risk factors, whereas higher SMD (OR 0.868, 95% CI 0.821-0.917, P < 0.001) and albumin (OR 0.866, 95% CI 0.801-0.936, P < 0.001) were protective factors. The nomogram showed good discrimination, with an AUC of 0.896, and remained stable after bootstrap validation (AUC 0.891). Calibration, DCA, CRP-adjusted analysis, and Fine-Gray regression supported model performance and robustness.
Conclusions: A nomogram integrating TyG, SMD, albumin, and smoking history showed good performance for predicting 3-year recurrence after first-episode HTG-AP and may support early risk stratification and individualized follow-up.
期刊介绍：
Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds.
Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
