Association of Glycaemic Control and Blood Pressure With Clinical Outcomes of Acute Pancreatitis in Obese Adult Men.

Background In obese adults, acute pancreatitis is often complicated by metabolic abnormalities, and suboptimal glycaemic control and hypertension may be linked to worse clinical outcomes and severity of disease. Objective To evaluate the association of glycaemic control and blood pressure status on clinical outcomes of acute pancreatitis in obese adult men. Methodology A prospective observational study was conducted at Pakistan Institute of Medical Sciences (PIMS), Islamabad, over one year (January 2025-December 2025). A total of 394 obese adult male patients with acute pancreatitis were enrolled using consecutive sampling. Clinical characteristics, laboratory parameters, glycaemic status, blood pressure, radiological findings, and clinical outcomes were assessed. HbA1c was categorized as <7% or ≥7% to characterize glycaemic status, while blood pressure was categorized as controlled or uncontrolled based on repeated inpatient measurements according to the prespecified threshold. Clinical outcomes were compared according to glycaemic and blood pressure status using Pearson chi-square tests. Multivariable logistic regression was performed to identify factors independently associated with severe acute pancreatitis, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported. Results Among 394 patients, 243 (61.68%) had HbA1c ≥7%, while 151 (38.32%) had HbA1c <7%. Uncontrolled blood pressure was observed in 222 (56.35%) patients compared with 172 (43.65%) with controlled blood pressure. Poor glycaemic status was associated with higher frequencies of severe acute pancreatitis (n=49; 20.16% vs. n=10; 6.62%), ICU admission (n=58; 23.87% vs. n=14; 9.27%), and in-hospital mortality (n=25; 10.29% vs. n=5; 3.31%) (all p<0.05). Uncontrolled blood pressure was associated with higher frequencies of severe acute pancreatitis (n=44; 19.82% vs. n=15; 8.72%), but the difference in in-hospital mortality was not statistically significant (n=22; 9.91% vs. n=8; 4.65%; p=0.051). In multivariable analysis, poor glycaemic control (AOR=2.84, 95% CI: 1.61-5.02, p<0.001) and uncontrolled blood pressure (AOR=2.31, 95% CI: 1.34-3.98, p=0.003) were independently associated with higher odds of severe acute pancreatitis. Conclusion Poor glycaemic control and uncontrolled blood pressure were associated with adverse clinical outcomes among obese adult men with acute pancreatitis. Poor glycaemic control and uncontrolled blood pressure were also independently associated with higher odds of severe acute pancreatitis in the final adjusted model. These findings support the clinical value of assessing metabolic characteristics in obese patients with acute pancreatitis, but the observational design does not establish causality or demonstrate that modifying these factors would improve outcomes. Further multicenter prospective and interventional studies are warranted to confirm these associations and determine whether targeted metabolic management can improve clinical outcomes.