Published online Nov 7, 2014. doi: 10.3748/wjg.v20.i41.15351
Revised: February 16, 2014
Accepted: April 2, 2014
Published online: November 7, 2014
AIM: To assess levels of serum resistin upon hospital admission as a predictor of acute pancreatitis (AP) severity.
METHODS: AP is both a common and serious disease, with severe cases resulting in a high mortality rate. Several predictive inflammatory markers have been used clinically to assess severity. This prospective study collected data from 102 patients who were diagnosed with an initial acute biliary pancreatitis between March 2010 and February 2013. Measurements of body mass index (BMI) and waist circumference (WC) were obtained and serum resistin levels were analyzed at the time of hospital admission using enzyme-linked immunosorbent assay. Additionally, resistin levels were measured from a control group after matching gender, BMI and age.
RESULTS: A total of 102 patients (60 females and 42 males) were diagnosed with acute gallstone-induced pancreatitis. The mean age was 45 years, and mean BMI value was 30.5 kg/m2 (Obese, class I). Twenty-two patients (21.6%) had severe AP, while eighty-eight patients had mild pancreatitis (78.4%). Our results showed that BMI significantly correlated with pancreatitis severity (P = 0.007). Serum resistin did not correlate with BMI, weight or WC. Furthermore, serum resistin was significantly higher in patients with AP compared to control subjects (P < 0.0001). The mean resistin values upon admission were 17.5 ng/mL in the severe acute biliary pancreatitis group and 16.82 ng/mL in the mild AP group (P = 0.188), indicating that resistin is not an appropriate predictive marker of clinical severity.
CONCLUSION: We demonstrate that obesity is a risk factor for developing severe AP. Further, although there is a correlation between serum resistin levels and AP at the time of hospital admission, resistin does not adequately serve as a predictive marker of clinical severity.
Core tip: Several predictive inflammatory markers have been used to predict pancreatitis severity. Peri-pancreatic adipose tissue synthesizes and secretes adipose-specific proteins, termed adipocytokines. One of these proteins, resistin, has immunomodulatory and metabolic activity. This novel adipose-driven protein, produced by pancreatic islets, may represent a useful additional marker for predicting acute pancreatitis (AP) severity. We found that serum resistin levels were significantly higher in patients with acute biliary pancreatitis compared to control subjects; however, resistin failed to serve as a predictive marker of clinical severity. Our study did find, however, that obesity correlated with severity of acute biliary pancreatitis. Based on the increased levels in AP patients upon hospital admission, we suggest that resistin could be used as a new diagnostic marker.