Impact of fatty liver on acute pancreatitis severity and prognosis: A meta-analysis of English and Chinese studies

BACKGROUND: Previous studies showed a significant correlation between fatty liver (FL) and acute pancreatitis (AP) onset, but the impact of FL on AP severity and prognosis remains uncertain. Therefore, we systematically searched existing publications in English and Chinese and conducted a meta-analysis to evaluate the effect of FL on AP severity and prognosis. OBJECTIVE: The purpose of this study was to analyze the correlation between FL and AP severity and prognosis. MATERIALS AND METHODS: All published controlled clinical studies on the relationship between FL and AP were identified by searching available electronic databases. We assessed the impact of FL disease on AP biochemical indicators, severity, and prognosis using pooled individual studies with an odds ratio (OR), standardized mean difference, and weighted mean difference. RESULTS: Thirteen clinical case − control studies met the meta-analysis entry criteria, and these studies included 6570 patients; among them, 2110 were patients with FL-relatedAP (FLAP) and 4460 were patients with non-FL-related AP (NFLAP). The meta-analysis results showed that the percentage of mild AP in FLAP was lower than that in NFLAP (OR = 0.32, P < 0.001), but the percentage of moderately severe AP (MSAP) and severe AP (SAP) in FLAP was higher than that in NFLAP (OR = 2.66 and 2.57, respectively, P < 0.001). The various prognostic indicators included the acute physiology and chronic health evaluation II score, systemic complications, local complications, total length of hospital stay, and mortality, which were all significantly higher in FLAP than in NFLAP (P < 0.05 for all). CONCLUSION: AP severity and prognosis were different between FLAP and NFLAP patients, and FL could be used as an independent risk factor for MSAP and SAP.