CTI May Help Predict Acute Pancreatitis Severity and Support Early Risk Stratification: Study

A new study published in the journal of Frontiers in Endocrinology showed that the C-reactive protein–triglyceride–glucose index was able to predict the severity of acute pancreatitis (AP) on its own with reasonable precision.

Acute pancreatitis (AP) is a condition characterized by inflammation that is becoming more common, with about 20% of individuals progressing to moderate-to-severe cases and a mortality rate of 20–40% in severe instances. The current tools used to predict outcomes have drawbacks such as delayed responses from biomarkers, complexity, and limited accessibility. CRP indicates inflammation, while the triglyceride–glucose (TyG) index shows insulin resistance (IR). Due to their interconnected nature, combining CRP and triglyceride–glucose into the composite CRP–triglyceride–glucose index (CTI) could enhance the ability to assess risk. This research aimed to assess CTI as an early indicator of the severity of AP.

In this retrospective cross-sectional research, patients diagnosed with acute pancreatitis (AP) from January 2019 to January 2026 were studied. The CTI was determined by the formula 0.412 × natural logarithm of CRP in mg/L + natural logarithm of triglycerides in mg/dL multiplied by fasting glucose in mg/dL divided by 2. The relationship between CTI and the severity of AP was examined through Spearman's correlation, logistic regression, and analysis of the receiver operating characteristic (ROC) curve. Severity was evaluated based on both the revised Atlanta criteria (RAC) and the modified computed tomography severity index (MCTSI).

In this research, 567 patients diagnosed with acute pancreatitis (AP) were studied. The group with a high CTI showed more severe AP compared to the low CTI group according to both the RAC and MCTSI grading systems (both P < 0.001).

Spearman’s rank correlation demonstrated a strong positive relationship (P < 0.001). In the statistical models, CTI was found to be an independent predictor of severity in both the RAC (odds ratio [OR] 1.180, 95% confidence interval [CI] 1.027–1.357, P = 0.019) and MCTSI (OR 1.436, 95% CI 1.237–1.667, P < 0.001).

The area under ROC curve (AUC) for MCTSI ≥ 8 was 0.763 (95% CI 0.681–0.845, P < 0.001) in the ROC curve analysis. The combination of CTI + white blood cell (WBC) + lactate dehydrogenase (LDH) produced the highest AUC values for all outcomes (range 0.697–0.795). Overall, CTI can predict the severity of acute pancreatitis fairly accurately on its own. Its regular availability and affordable price make it a useful additional tool for early risk assessment.

Source:

Xu, T., Gao, Y., Zhang, Z., Lin, L., & Ding, Z. (2026). C-reactive protein-triglyceride-glucose index predicts acute pancreatitis severity: a retrospective cross-sectional study. Frontiers in Endocrinology, 17(1964371), 1964371. https://doi.org/10.3389/fendo.2026.1964371