Özgür YILMAZ, Sami ÇİFÇİ
Comprehensive Medicine - 2026;18(1):73-80
Objective: Acute pancreatitis (AP) varies in severity, making early identification of severe acute pancreatitis (SAP) essential. As lipid imbalance has been increasingly linked to inflammatory activation, the Atherogenic Index of Plasma (AIP) has been proposed as a potential prognostic marker. This study evaluated the association between AIP and AP severity and assessed whether AIP independently predicts SAP. Materials and Methods: This retrospective cohort included 203 adult patients with acute pancreatitis. Classification of acute pancreatitis followed the Revised Atlanta Criteria. Demographic, laboratory, and lipid data were extracted from electronic records, and AIP was calculated using triglyceride and HDL-cholesterol values. Analyses included group comparisons, correlation testing, comprehensive ROC analyses, multivariable logistic regression, and a covariate-adjusted ROC. Results: Among 203 patients, 128 had MAP and 75 had SAP. SAP patients showed significantly higher WBC, glucose, creatinine, AST, ALT, and CRP levels (all p<0.001) and lower HDL-C (p=0.024). Mean AIP was higher in SAP (0.59+/-0.15 vs. 0.53+/-0.20; p=0.016) but demonstrated limited discrimination (AUC 0.575; cut-off 0.390; sensitivity 96.0%, specificity 22.7%). AIP was significant in unadjusted and WBC-adjusted models (p=0.023 and p=0.043, respectively), but not in the fully adjusted model including WBC and glucose (p=0.196). The covariate-adjusted ROC showed excellent accuracy (AUC 0.892; sensitivity 84.0%, specificity 79.7%). Conclusion: Although higher in severe cases, AIP did not independently predict severity. While insufficient alone, AIP may contribute supportive value when combined with inflammatory and metabolic markers.
