Acute pancreatitis in pregnancy (APIP) varies in severity from a self-limiting mild condition to a severe life-threatening condition, and its severity is significantly correlated with higher risks of maternal and foetal death. This study evaluated the early predictive value of routine laboratory tests on the severity of APIP patients. We enrolled 100 patients with APIP in West China Hospital. Initial routine laboratory tests, including the biochemistry and hematologic tests were collected within 48 hours after the onset of APIP. For predicting SAP in AP, LDH had the highest specificity of 0.879. RDW was a suitable predictive marker as it had the sensitivity of 0.882. Lower levels of triglycerides (<4.72 mmol/L) predicted mild AP of APIP, with an area under the curve (AUC) of 0.724, and a negative predictive value of 0.80. Furthermore, a risk score was calculated based on white blood cells, neutrophils, RDW, LMR and LDH, as an independent marker (adjusted odds ratio = 3.013, 95% CI 1.893 to 4.797, P < 0.001), with the highest AUC of 0.906, a sensitivity of 0.875 and a specificity of 0.828. In conclusion, the risk score we recommended was the powerful marker to aid in the early prediction of the severity of APIP patients.

Excessive consumption of ultra-processed foods (UPFs) containing non-nutritive sweeteners (NNS) has been implicated in inflammatory bowel disease (IBD), yet the effects of erythritol on intestinal inflammation remain poorly understood. In this study, we assessed NNS-containing UPF exposure in patients with IBD and healthy controls, and then investigated the effects of erythritol in a dextran sulfate sodium (DSS)-induced colitis. Food frequency questionnaire (FFQ) results showed that patients with IBD, particularly those with active disease, had a higher proportion of NNS-containing UPF categories among total UPFs consumed. In mice, erythritol administration exacerbated DSS-induced colitis, as evidenced by sustained body weight loss, increased disease activity index, impaired intestinal barrier integrity, and elevated inflammatory cytokine expression. Transcriptomic analysis revealed significant enrichment of ferroptosis-related pathways in the colonic mucosa of erythritol-treated colitic mice. Furthermore, erythritol markedly altered gut microbial composition, characterized by increased abundance of potentially pathogenic bacteria and enrichment of Alistipes sp. CHKCI003. Untargeted metabolomics demonstrated alteration of tryptophan metabolism. Consistently, erythritol aggravated depression-like behavior in DSS-induced mice. Collectively, these findings suggest that erythritol exacerbates experimental colitis and depression-like behavior, potentially through microbiota dysbiosis, ferroptosis-associated alterations, and disrupted tryptophan metabolism.