Admission METS-IR in relation to severe acute pancreatitis among patients with hypertriglyceridemic acute pancreatitis: a retrospective cohort study
- 1Department of Gastroenterology, Bishan Hospital of Chongqing Medical University , ,
- 2Department of Endocrinology, Bishan Hospital of Chongqing Medical University , ,
Abstract
Background
Hypertriglyceridemic acute pancreatitis (HTG-AP) is accompanied by significant metabolic abnormalities, but few studies have investigated whether a composite measure of this metabolic burden is associated with severe acute pancreatitis (SAP). The metabolic score for insulin resistance (METS-IR), derived from fasting glucose, high-density lipoprotein cholesterol, triglycerides, and body mass index, can be calculated from routinely available clinical data without requiring an insulin assay. However, its association with SAP in HTG-AP remains poorly characterized.Objective
This study investigates the association between admission METS-IR and SAP in patients with HTG-AP and assesses the robustness of this association through subgroup and sensitivity analyses.Methods
We retrospectively assembled a single-center cohort of 456 adults admitted with HTG-AP between January 2019 and July 2025. Logistic regression evaluated METS-IR as a continuous exposure and in quartiles. Restricted cubic splines, subgroup analyses, and sensitivity analyses were performed. Exploratory ROC analyses compared apparent discrimination with TyG, TyG-BMI, and BISAP.Results
SAP occurred in 78 of 456 patients (17.1%). Median METS-IR was 69.99 (IQR, 61.92-83.67) in the SAP group and 58.18 (IQR, 51.47-66.46) in the non-SAP group. In Model 3, each one-point increase in METS-IR was associated with higher odds of SAP (OR, 1.06; 95% CI, 1.04-1.08). After additional adjustment for TG, TG/HDL-C, and TyG, the estimate was attenuated (OR, 1.03; 95% CI, 0.997-1.064; P = 0.073). Apparent AUCs were 0.730 for METS-IR, 0.720 for TyG, and 0.758 for BISAP; neither paired comparison showed a statistically significant difference. In the three-category analysis, the METS-IR association was stronger for SAP vs. MAP than for MSAP vs. MAP.Conclusion
Higher admission METS-IR was independently associated with higher odds of SAP in patients with HTG-AP. METS-IR may provide a readily available measure of metabolic burden for early clinical assessment of patients with HTG-AP, although its clinical utility requires confirmation in prospective multicenter studies.
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BibTeX
@article{zhang2026admission,
title = {{Admission METS-IR in relation to severe acute pancreatitis among patients with hypertriglyceridemic acute pancreatitis: a retrospective cohort study}},
author = {Ziyi Zhang and Changwei Peng and Hong Peng and Yuanxia Zhu and Chenghu Huang and Li Rong},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1999625},
url = {https://europepmc.org/article/PMC/PMC13717400},
note = {CC BY},
}
RIS
TY - JOUR
TI - Admission METS-IR in relation to severe acute pancreatitis among patients with hypertriglyceridemic acute pancreatitis: a retrospective cohort study
AU - Ziyi Zhang
AU - Changwei Peng
AU - Hong Peng
AU - Yuanxia Zhu
AU - Chenghu Huang
AU - Li Rong
PY - 2026
DA - 2026/10/15
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1999625
UR - https://europepmc.org/article/PMC/PMC13717400
AB - Background Hypertriglyceridemic acute pancreatitis (HTG-AP) is accompanied by significant metabolic abnormalities, but few studies have investigated whether a composite measure of this metabolic burden is associated with severe acute pancreatitis (SAP). The metabolic score for insulin resistance (METS-IR), derived from fasting glucose, high-density lipoprotein cholesterol, triglycerides, and body mass index, can be calculated from routinely available clinical data without requiring an insulin assay. However, its association with SAP in HTG-AP remains poorly characterized.Objective This study investigates the association between admission METS-IR and SAP in patients with HTG-AP and assesses the robustness of this association through subgroup and sensitivity analyses.Methods We retrospectively assembled a single-center cohort of 456 adults admitted with HTG-AP between January 2019 and July 2025. Logistic regression evaluated METS-IR as a continuous exposure and in quartiles. Restricted cubic splines, subgroup analyses, and sensitivity analyses were performed. Exploratory ROC analyses compared apparent discrimination with TyG, TyG-BMI, and BISAP.Results SAP occurred in 78 of 456 patients (17.1%). Median METS-IR was 69.99 (IQR, 61.92-83.67) in the SAP group and 58.18 (IQR, 51.47-66.46) in the non-SAP group. In Model 3, each one-point increase in METS-IR was associated with higher odds of SAP (OR, 1.06; 95% CI, 1.04-1.08). After additional adjustment for TG, TG/HDL-C, and TyG, the estimate was attenuated (OR, 1.03; 95% CI, 0.997-1.064; P = 0.073). Apparent AUCs were 0.730 for METS-IR, 0.720 for TyG, and 0.758 for BISAP; neither paired comparison showed a statistically significant difference. In the three-category analysis, the METS-IR association was stronger for SAP vs. MAP than for MSAP vs. MAP.Conclusion Higher admission METS-IR was independently associated with higher odds of SAP in patients with HTG-AP. METS-IR may provide a readily available measure of metabolic burden for early clinical assessment of patients with HTG-AP, although its clinical utility requires confirmation in prospective multicenter studies.
SN - 2296-858X
ER -