TSH as a novel biomarker for recurrence of hypertriglyceridemia pancreatitis: a clinical predictive tool linking lipid dysregulation to inflammation

Pancreatology. 2025 Sep;25(6):849-859. doi: 10.1016/j.pan.2025.07.417. Epub 2025 Aug 5.

Abstract

Backgrounds: With the change in dietary patterns, the number of patients suffering from hypertriglyceridemia-induced acute pancreatitis (HTG-AP) has been increasing year by year. HTG-AP patients have a higher likelihood of progressing to severe conditions and exhibit a markedly increased risk of recurrence compared to other etiologies. At present, effective prediction models for the recurrence of HTG-AP need to be established and improved urgently, which is of great significance in improving the prognosis of patients.

Methods: A total of 429 HTG-AP patients were included in this study. Variables were selected by LASSO regression to construct a Logistic regression prediction model, and the performance of the model was verified by ROC curve, calibration curve and decision curve analysis (DCA).

Results: Elevated Thyroid-stimulating hormone (TSH) and triglyceride (TG) levels, Female and Age >33 years were identified as independent risk factors (P < 0.05). A further dietary retrospective study found that the intake of fat and carbohydrate in the recurrent HTG-AP (RAP) group was significantly higher than that in the primary HTG-AP (OAP) group (P < 0.01), while the salt intake was much lower.

Conclusion: Elevated TSH was likely to be an independent risk factor for HTG-AP recurrence. In addition, the new nomogram model based on TSH level shows high accuracy in predicting HTG-AP recurrence, which is expected to provide certain help for clinical prevention and treatments.

Keywords: Hypertriglyceridemia; Prediction model; Recurrent acute pancreatitis; TSH.

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Female
  • Humans
  • Hypertriglyceridemia* / blood
  • Hypertriglyceridemia* / complications
  • Inflammation / blood
  • Male
  • Middle Aged
  • Pancreatitis* / blood
  • Pancreatitis* / diagnosis
  • Pancreatitis* / etiology
  • Prognosis
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Thyrotropin* / blood
  • Triglycerides / blood

Substances

  • Biomarkers
  • Thyrotropin
  • Triglycerides