Ghrelin and gastroparesis as early predictors of clinical outcomes inacute pancreatitis.

Abstract

Impaired motor and hormonal gastrointestinal functions have been implicated in the pathogenesis of acute pancreatitis. The aim of the present study was to investigate the predictive value of the Gastroparesis Cardinal Symptom Index and serum ghrelin in the development of clinically meaningful outcomes in patients with acute pancreatitis. This was a prospective clinical study. The Gastroparesis Cardinal Symptom Index and serum ghrelin were measured for 48h after hospitalization. Univariate and multivariate logistic regression analyses were conducted. The Gastroparesis Cardinal Symptom Index total score alone on day 2 was a significant predictor of oral feeding intolerance in both unadjusted (odds ratio 1.21 (1.01-1.46), P=0.04) and adjusted (odds ratio 1.30 (1.01-1.69), P=0.05) analyses. Adding ghrelin to Gastroparesis Cardinal Symptom Index further improved prediction in both unadjusted (odds ratio 1.26 (1.02-1.56), P=0.03) and adjusted (odds ratio 1.53 (1.00-2.35), P=0.05) analyses. This pilot study demonstrates that the Gastroparesis Cardinal Symptom Index has a potential to be used as a predictor of oral feeding intolerance. Ghrelin, when combined with the Gastroparesis Cardinal Symptom Index, may further improve the predictive accuracy. These findings need to be confirmed in larger studies.