Fecal elastase-1 cut-off levels in the assessment of exocrine pancreatic function in cystic fibrosis.
BACKGROUND
Fecal elastase-1 (E1) test is a sensitive and specific indirect test. However, there are few data on the best cut-off level in the assessment of exocrine pancreatic function in cystic fibrosis (CF).


METHODS
In 725 CF patients and 243 healthy subjects (HS) from Greece, Russia, Poland and the United Kingdom, E1 concentrations were measured. The best cut-off levels for the discrimination between CF and HS (for whole group as well as for individual countries) were calculated.


RESULTS
The best cut-off level for the differentiation between CF pancreatic insufficiency and normal pancreatic function in HS was found to be 184 microg/g of feces. However, some inter-country differences were stated. E1 concentrations in the UK subgroup were significantly lower than those found in Polish and Russian CF patients. E1 concentrations in Greek patients were significantly higher than in the other countries. However, E1 concentrations in Delta F508 homozygotes were very similar in all studied subgroups.


CONCLUSIONS
In clinical practice, instead of a single best cut-off level for the E1 test, we suggest using a range of values (160-200 microg/g). The presence of different best cut-off levels within countries is a practical consequence of the different distribution of pancreatic function.
Institute of Pediatrics, Department of Gastroenterology and Metabolism, Karol Marcinkowski University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland. jarwalk@am.poznan.pl
Jaroslaw
J
Walkowiak
Sanda
S
Nousia-Arvanitakis
Alan
A
Cade
Natasha
N
Kashirskaya
Robert
R
Piotrowski
Krystyna
K
Strzykala
Maria
M
Kouniou
Andrzej
A
Pogorzelski
Dorota
D
Sands
Nikolai
N
Kapranov
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications*; D005060:Europe; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010179:Pancreas / Q000503:physiopathology; D010196:Pancreatic Elastase / Q000032:analysis*; D012016:Reference Values
D010196:Pancreatic Elastase