TO DETERMINE WHETHER LACTATE DEHYDROGENASE OR HDL/MONOCYTE RATIO IS A BETTER PREDICTOR OF SEVERE ACUTE PANCREATITIS

Abstract

Background: Acute pancreatitis is an inflammatory condition of the pancreas that may progress to systemic inflammatory response syndrome (SIRS) and multi-organ dysfunction syndrome (MODS), significantly increasing morbidity and mortality. Traditional laboratory markers such as amylase and lipase aid in diagnosis but fail to predict severity. Emerging biomarkers, including the High-Density Lipoprotein to Monocyte Ratio (HDL/MR) and serum Lactate Dehydrogenase (LDH), may provide valuable insights into disease severity.

Aim: To compare the reliability of HDL/Monocyte ratio and serum LDH in predicting the severity of acute pancreatitis.

Methods:
 A cross-sectional study was conducted at Saveetha Medical College and Hospital in 2024 on 50 patients diagnosed with acute pancreatitis. Inclusion criteria were biliary or alcohol-induced acute pancreatitis presenting within 48 hours. Severity was assessed using Ranson’s score (≥3 = severe). Blood samples were collected on admission to measure lipid profile, complete blood count, and serum LDH. Statistical analysis was performed using SPSS, with p < 0.05 considered significant.

Results: Among 50 patients, 33 had mild and 17 had severe acute pancreatitis. The mean HDL/Monocyte ratio was significantly lower in severe cases (0.033 ± 0.013) compared to mild cases (0.085 ± 0.026, p < 0.01). Serum LDH levels were markedly higher in severe cases (704.82 ± 563.43 U/L) than in mild cases (185.78 ± 48.39 U/L, p < 0.001). Both biomarkers showed strong statistical significance, with no major difference in predictive value.

Conclusion: Both HDL/Monocyte ratio and serum LDH are reliable predictors of severe acute pancreatitis. While LDH demonstrated greater variability, both markers can aid in early risk stratification. Larger multicenter studies are needed to validate cutoff values and integrate these markers into prognostic models for improved patient outcomes.