Abstract
BackgroundRecent studies have shown that bile acids (BAs) are closely related to metabolic and inflammatory diseases. Our study aimed to investigate whether circulating total bile acid (TBA) levels were associated with the severity of acute pancreatitis (AP).MethodsWe retrospectively collected data on patients diagnosed with AP in a tertiary center from 01 January 2014 to 31 December 2016. The highest TBA value during the first 1,2,3,5,7 days after admission was determined as D1, D2, D3, D5, D7 TBAmax. Patients were divided into the high TBA (HTBA) group and the normal TBA (NTBA) group according to whether the TBAmax was ≥10 μmol/L. The prognosis and complications, including death, organ failure (OF) and pancreatic necrosis, were compared between the two groups. Logistic regression analysis and receiving operating characteristic (ROC) curve were used to evaluate the relationship between circulating TBA and organ failure in AP patients.ResultsThrough stratified analysis of each time period, we found that the incidence of OF in the HTBA group was significantly higher than that in the NTBA group, and the AP severity classification in the HTBA group was more serious than that in the NTBA group. In addition, according to the D7 TBAmax values, the pancreatic necrosis rate, percutaneous catheter drainage (PCD) rate and mortality in the HTBA group were higher than those in the NTBA group. Multivariate regression analysis showed that HTBA (odds ratio (OR), 4.894; P = 0.002) was an independent risk factor for AP complicated with OF, which was verified in the grouping based on D7 TBAmax. ROC analysis revealed that a circulating D7 TBAmax cutoff point of 6.450 umol/L had optimal predictive value for the development of OF in AP patients with an area under the curve of the ROC curve (AUCROC) of 0.777.ConclusionsThe increase of circulating TBA in early stage of AP is independently related to organ failure, which indicates the adverse prognosis of AP patients.
Highlights
Recent studies have shown that bile acids (BAs) are closely related to metabolic and inflammatory diseases
The results showed that elevated levels of circulating total bile acid (TBA) in the early stages of acute pancreatitis (AP) were closely related to the development of organ failure
Patient demographics and clinical characteristics In our study, 1097 AP patients admitted to the Pancreatitis Treatment Center of Jinling Hospital from 01 January 2014 to 31 December 2016 were screened
Summary
Recent studies have shown that bile acids (BAs) are closely related to metabolic and inflammatory diseases. Our study aimed to investigate whether circulating total bile acid (TBA) levels were associated with the severity of acute pancreatitis (AP). About 15–20% of AP patients whose inflammation is not limited to the pancreas, and involving the peripancreatic tissue and other distant organs, secondary to the local or systemic complications, developed into severe acute pancreatitis (SAP) [3, 4]. Some studies illuminated that the levels of circulating TBA were elevated in patients with metabolic diseases such as obesity and type 2 diabetes [17,18,19,20]
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