ArticleArchive of clinical cases2025
Obesity alters metabolic profiles in children with acute pancreatitis, but not disease severity and recurrence: a Romanian cohort study.
Article in Archive of clinical cases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Childhood obesity has been increasingly recognized as a risk factor for acute pancreatitis (AP). This study investigates the impact of obesity and a novel composite metabolic risk variable (MAC - Metabolic at Risk in Context) on the biochemical, inflammatory, and clinical profiles of Romanian children with AP. MATERIAL AND
methodsA retrospective cohort study included 90 pediatric patients hospitalized for a first episode of AP at Grigore Alexandrescu Children's Emergency Clinical Hospital in Bucharest over a three-year period. Patients were classified as obese or non-obese based on BMI percentiles. The MAC variable was defined as positive if the patient had at least one of the following: total cholesterol >170 mg/dL, GGT >40 U/L, or total lipids >500 mg/dL. Associations between obesity, MAC, inflammatory markers, disease severity, and recurrence were analyzed using regression models.
resultsNineteen patients (21.1%) were obese, and 35 (38.9%) were MAC-positive. Obese patients were older (median age 15 vs. 9.5 years) and had significantly higher total cholesterol, GGT, and total lipid levels. MAC positivity was more frequent in obese patients (68.4% vs. 26.8%, p < 0.001). Biliary pancreatitis was significantly more common among obese patients (p = 0.0043), while no association was found between MAC and biliary etiology. Neither obesity nor MAC predicted severity or recurrence. In contrast, lower lymphocyte counts were inversely associated with severity (p<0.01), suggesting that lymphopenia may serve as a biomarker of severe disease.
conclusionsObesity and metabolic abnormalities are frequent in pediatric AP and are associated with biliary etiology, but not with increased severity or recurrence. The use of the MAC variable provides a novel approach to identify children at metabolic risk beyond BMI status. Additionally, lymphocyte counts may serve as a practical biomarker for identifying children at risk for severe AP. These findings highlight the need for integrated metabolic and immune assessments in pediatric AP management.
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