Low serum trypsinogen levels in chronic pancreatitis: Correlation with parenchymal loss, exocrine pancreatic insufficiency, and diabetes but not CT-based cambridge severity scores for fibrosis.
Acinar Cells
Adult
Aged
Atrophy
Biomarkers
/ blood
Calcinosis
/ pathology
Cohort Studies
Diabetes Complications
/ blood
Exocrine Pancreatic Insufficiency
/ blood
Female
Fibrosis
Humans
Male
Middle Aged
Pancreas
/ pathology
Pancreatic Ducts
/ pathology
Pancreatitis, Chronic
/ blood
Severity of Illness Index
Surveys and Questionnaires
Tomography, X-Ray Computed
Trypsinogen
/ blood
Malnutrition
Pancreatic acinar cell
Pancreatic beta cell
Pancreatic stellate cell
Pathologic calcification
Journal
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
29
07
2020
revised:
26
08
2020
accepted:
30
08
2020
pubmed:
25
9
2020
medline:
18
9
2021
entrez:
24
9
2020
Statut:
ppublish
Résumé
Chronic pancreatitis (CP) is a complex inflammatory disorder of the pancreas affecting acinar cells, duct cells, islet cells and inflammatory cells including fibrosis-producing stellate cells. Serum trypsinogen is a biomarkers of acinar cell function. To define the degree of correlation between low trypsinogen levels as a marker of acinar cell function and variable features of CP. Serum samples from previously ascertained and well phenotyped case and control subjects from the North American Pancreatitis Study II (NAPS2) were used to measure serum trypsinogen levels in a commercial laboratory. Control samples were used to define normal ranges and compared with levels in CP patients with defined features. A final cohort of 279 CP patients and 262 controls from the NAPS2 studies were evaluated. In controls trypsinogen had a mean of 34.96 ng/ml and SD = 11.99. Cut-off values for low trypsinogen ranged from <20 to 10 ng/ml and very low trypsinogen at <10 ng/ml. Compared to controls, CP was associated with very low trypsinogen levels (p < 0.0001). Within CP, very low trypsinogen levels correlated with parenchymal loss (pancreatic surgery [p < 0.05]; atrophy with calcifications, [p < 0.001]), EPI (p < 0.01, trend p < 0.001) and diabetes (trend p < 0.01) but not CT-based criteria for fibrosis (pancreatic duct dilation, irregularity, strictures). Very low serum trypsinogen levels correlate with measures of acinar cell loss including surgical resection, atrophic-calcific CP, diabetes and functional symptoms EPI but not duct morphology criteria. Serum trypsinogen levels correlate with decreased acinar cell function and therefore have biomarker utility clinical management.
Sections du résumé
BACKGROUND
BACKGROUND
Chronic pancreatitis (CP) is a complex inflammatory disorder of the pancreas affecting acinar cells, duct cells, islet cells and inflammatory cells including fibrosis-producing stellate cells. Serum trypsinogen is a biomarkers of acinar cell function.
AIM
OBJECTIVE
To define the degree of correlation between low trypsinogen levels as a marker of acinar cell function and variable features of CP.
METHODS
METHODS
Serum samples from previously ascertained and well phenotyped case and control subjects from the North American Pancreatitis Study II (NAPS2) were used to measure serum trypsinogen levels in a commercial laboratory. Control samples were used to define normal ranges and compared with levels in CP patients with defined features.
RESULTS
RESULTS
A final cohort of 279 CP patients and 262 controls from the NAPS2 studies were evaluated. In controls trypsinogen had a mean of 34.96 ng/ml and SD = 11.99. Cut-off values for low trypsinogen ranged from <20 to 10 ng/ml and very low trypsinogen at <10 ng/ml. Compared to controls, CP was associated with very low trypsinogen levels (p < 0.0001). Within CP, very low trypsinogen levels correlated with parenchymal loss (pancreatic surgery [p < 0.05]; atrophy with calcifications, [p < 0.001]), EPI (p < 0.01, trend p < 0.001) and diabetes (trend p < 0.01) but not CT-based criteria for fibrosis (pancreatic duct dilation, irregularity, strictures).
CONCLUSIONS
CONCLUSIONS
Very low serum trypsinogen levels correlate with measures of acinar cell loss including surgical resection, atrophic-calcific CP, diabetes and functional symptoms EPI but not duct morphology criteria. Serum trypsinogen levels correlate with decreased acinar cell function and therefore have biomarker utility clinical management.
Identifiants
pubmed: 32967795
pii: S1424-3903(20)30674-8
doi: 10.1016/j.pan.2020.08.025
pii:
doi:
Substances chimiques
Biomarkers
0
Trypsinogen
9002-08-8
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1368-1378Informations de copyright
Copyright © 2020. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of competing interest DCW serves as a consultant to AbbVie, Regeneron and Ariel Precision Medicine and may have financial interest in Ariel Precision Medicine, MAA served as a consultant to GSK and Boehringer-Ingelheim. MDB serves as a consultant to Ariel Precision Medicine and NovoNordisk.