Association between neutrophil to high-density lipoprotein cholesterol ratio and disease severity in patients with acute biliary pancreatitis

The neutrophil to high-density lipoprotein cholesterol ratio (NHR) is independently associated with the severity of various diseases. However, its association with acute biliary pancreatitis (ABP) remains unknown. This study included 1335 eligible patients diagnosed with ABP from April 2016 to December 2022. Patients were divided into low- and high-NHR level groups using an optimal cut-off value determined utilizing Youden’s index. Multivariate logistic regression analysis was used to investigate the correlation between NHR and ABP severity. Multivariate analysis-based limited restricted cubic spline (RCS) method was used to evaluate the nonlinear relationship between NHR and the risk of developing moderate or severe ABP. In this study, multivariate logistic regression analysis indicated an independent association between NHR and ABP severity (p  0.05), and increased NHR was found to be independently associated with a more severe form of the disease. Our study suggests that NHR is a simple and practical independent indicator of disease severity, serving as a potential novel predictor for patients with ABP. This study is the first to report on the independent association between the neutrophil to high-density lipoprotein cholesterol ratio (NHR) and acute biliary pancreatitis (ABP) severity. The restricted cubic spline analysis showed a linear correlation between NHR and the risk of developing moderate or severe ABP. Increased NHR levels are independently associated with a more severe degree of the disease.</p