Neutrophils promoted the spread of inflammation via secretion a series of inflammatory cytokines (interleukin‐1, interleukin‐6), proteolytic enzymes (myeloperoxidase, elastase, collagenase), and reactive oxygen species.24 It was reported that higher NLR value represented a more imbalanced inflammatory state.14 Therefore, our results which showed NLR could selectively predict the severity of HTG‐AP and was more sensitive and accurate than WBC in judging the severity can be explained as NLR could be regarded as a representative of imbalanced inflammatory cascade reaction. Here, MPO is linked to alkaline phosphatase measurement.