The Correlation Analysis of C-Reactive Protein-Triglyceride-Glucose Index with the Severity of Hyperlipidemic Acute Pancreatitis.

Abstract

Background: The novel serum C-reactive protein-triglyceride-glucose index (CTI) has been identified as an optimal biomarker integrating inflammation and insulin resistance (IR), which are the potential pathogenic mechanisms underlying hyperlipidemic acute pancreatitis (HLAP). This study aims to investigate the association between CTI and the severity of HLAP.

Objective: To investigate the correlation between the serum CTI and the severity of HLAP.

Methods: We conducted a retrospective study including 113 consecutive patients with HLAP admitted to the Guizhou Hospital of the First Affiliated Hospital of Sun Yat-sen University from July 2021 to November 2025. Patients were classified into severe and non-severe groups based on the Revised Atlanta Classification of Acute Pancreatitis. Logistic regression, subgroup analysis, restricted cubic spline (RCS) regression, and receiver operating characteristic (ROC) analysis were performed to explore the association between CTI and the severity of HLAP.

Results: A total of 113 patients with HLAP were enrolled in this study, including 69 cases in the severe group and 44 cases in the non-severe group. The results demonstrated that the CTI was positively correlated with the severity of HLAP, regardless of covariate adjustment (odds ratio (OR) = 1.55, 95%CI 1.04-2.30, P = 0.03). The continuous variable CTI was further divided into four quartiles, followed by logistic regression analysis. Compared with the population in the lowest CTI quartile, the population in the highest CTI quartile showed a significantly higher risk of severe acute pancreatitis (SAP) after adjusting for confounding factors (OR = 6.0, 95%CI 1.37-26.21, P = 0.02). This finding was further verified by subgroup analysis. RCS analysis revealed a linear positive correlation between CTI and the risk of SAP. According to ROC curve analysis, CTI demonstrated a higher specificity and a larger AUC, suggesting superior overall discriminative performance compared with the Bedside Index for Severity in Acute Pancreatitis (BISAP) score. These findings suggested that the CTI has good predictive efficacy for the severity of HLAP.

Conclusion: The CTI is positively correlated with the severity of HLAP, highlighting that the CTI is a potential clinical indicator for identifying and stratifying the severity of HLAP, which further guides clinical decision-making.