. Diagnostic value of HMGB-1 and Acetylcholinesterase in Assessing the Prognosis of Patients with Acute Pancreatitis

Abstract

Listen

Translate article

Aim: Acute pancreatitis (AP) is a disorder of tissue digestion caused by abnormal activation of pancreatic enzymes, which may lead to multi-organ failure and ultimately death as the disease progresses. How to quickly and accurately evaluate the progression of AP has always been a hotspot and difficulty in clinical research. Methods: Sixty-four AP patients admitted to our hospital from August 2022 to June 2023 and 60 concurrent healthy people were selected as the research subjects, with AP patients as the observation group and healthy people as the control group. Using kits from Wuhan Fine Biotechnology Co., Ltd., an enzyme-linked immunosorbent assay (ELISA) was carried out to measure HMGB-1 and AChE levels. In addition, an automatic biochemical analyzer was utilized to quantify the levels of nutritional proteins albumin (ALB), transferrin (TRF), and total protein (TP) in the observation group. Results: Compared with the control group, the HMGB-1 in the observation group was higher while the AChE was lower (P<0.05). ROC curve analysis showed that when HMGB-1 was less than 7.25 mg/L, the sensitivity and specificity for diagnosing AP were 89.06% and 51.67%, respectively (P<0.05); when AChE was less than 6.18 U/L, the sensitivity for diagnosing AP was 43.75% and the specificity was 90.00% (P<0.05). Using the joint detection Log(P)=-1.736+(0.645×HMGB-1)+(-0.454×AChE), it was found that HMGB-1+AChE had a sensitivity of 48.44% and a specificity of 88.33% for the diagnosis of AP (P<0.05, cut-off>0.639,) Conclusion: In this study, we found elevated HMGB-1 expression in AP and reduced acetylcholinesterase (AChE), suggesting that both of them may be involved in the occurrence and development of AP. Meanwhile, the two demonstrated excellent diagnostic efficacy in the onset and poor prognosis of AP, and were closely related to AP progression, confirming their potential as new clinical indicators for AP. Due to the self-digestion by pancreatic enzymes, the nutritional metabolism of AP patients is disrupted, so protein loss is also a focus of attention. In this study, we also found a negative correlation of nutritional protein levels with HMGB-1 in AP patients and a positive correlation between them with AChE, further supporting the relationship between the two and AP progression. The findings can lay a reliable foundation for future research on the diagnosis and treatment of AP based on HMGB-1 and AChE.