Objective To explore the correlation of triglyceride-glucose index (TyG index) with moderately severe and severe acute pancreatitis (MS-SAP) complicated with acute kidney injury (AKI).

Methods Clinical materials of 161 patients initially diagnosed as MS-SAP in the Affiliated Hospital of Yangzhou University from January 2018 to July 2022 were retrospectively collected, and they were divided into AKI group with 75 cases and non-AKI group with 86 cases according to the incidence of AKI. Clinical materials, laboratory indicators and TyG index were compared between two groups. Pearson correlation analysis was used to evaluate the correlations of TyG index with clinical materials and laboratory indicators; the Logistic regression analysis was used to explore the independent risk factors of MS-SAP patients complicated with AKI.

Results There were significant differences in the Sequential Organ Failure Assessment score (SOFA score), the pancreatitis severity score (Ranson score) and the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score between the AKI group and the non-AKI group (P < 0.05). Compared with the non-AKI group, the levels of serum glucose (GLU), C reactive protein (CRP), triglyceride (TG), total cholesterol(TC), serum creatinine (Scr) and TyG index in the AKI group increased significantly, while the levels of high-density lipoprotein (HDL) and calcium ion decreased significantly (P < 0.05). Pearson correlation analysis showed that TyG index was positivelycorrelated with complicated diabetes, the SOFA score, the APACHE Ⅱ score, TC, CRP and Scr (P < 0.05), but was negatively correlated with age, complicated hypertension, HDL, alanine transaminase (ALT), aspartate transaminase (AST), magnesium ion and calcium ion (P < 0.05). Logistic regression analysis showed that the TyG index and SOFA score were the independent influencing factors of MS-SAP patients complicating with AKI (P < 0.05).

Conclusion The TyG index level in MS-SAP patients complicated with AKI increases obviously. High level of TyG index may be one of the influencing factors for the occurrence of AKI in MS-SAP patients, and insulin resistance is one of the possible mechanisms involved in the occurrence of AKI in MS-SAP.