Biochemical parameters in the early differentiation of the etiology of acute pancreatitis.
OBJECTIVE
We undertook a retrospective study to define the usefulness of various biochemical parameters in differentiation between alcoholic and nonalcoholic acute pancreatitis.


METHODS
One hundred sixty-seven patients were divided into groups A (alcoholic pancreatitis) and NA (nonalcoholic pancreatitis). Group NA was further subdivided into groups B (biliary pancreatitis) and NANB (nonalcoholic, nonbiliary pancreatitis). The values of serum and urine amylase, serum lipase, AST, ALT, alkaline phosphatase, gamma glutamyl transferase, bilirubin, lipase/amylase ratio, and erythrocyte mean corpuscular volume were investigated.


RESULTS
Serum amylase, ALT, AST, alkaline phosphatase (p < 0.001), and urine amylase (p < 0.01) were significantly lower in patients with alcoholic pancreatitis. Erythrocyte mean corpuscular volume and lipase/amylase ratio were significantly higher in patients with alcoholic pancreatitis (p < 0.001). There were no differences in lipase, bilirubin, and gamma glutamyl transferase between patients with alcoholic pancreatitis and those with nonalcoholic pancreatitis. Multivariate analysis showed that a combination of three variables (lipase/amylase ratio, erythrocyte mean corpuscular volume, and alkaline phosphatase) differentiated between alcoholic and nonalcoholic pancreatitis.


CONCLUSIONS
Various biochemical parameters used together and with other clinical features can help in the early differentiation between alcoholic and nonalcoholic acute pancreatitis.
Stimac
D
D
Internal Clinic, Clinical Hospital Center Rijeka, Croatia.
Rubinić
M
M
Lenac
T
T
Kovac
D
D
Vcev
A
A
Miletic
D
D
D000208:Acute Disease; D000328:Adult; D001660:Biliary Tract Diseases / Q000150:complications; D001663:Bilirubin / Q000097:blood; D016022:Case-Control Studies; D004796:Clinical Enzyme Tests; D003937:Diagnosis, Differential; D004911:Erythrocyte Volume; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology*; D019512:Pancreatitis, Alcoholic / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors
D001663:Bilirubin