title: Disialotransferrin, determined by capillary electrophoresis, is an accurate biomarker for alcoholic cause of acute pancreatitis.
abstract: OBJECTIVE
  Serum disialotransferrin is a specific marker of heavy alcohol consumption. We tested its accuracy and probability in detecting alcoholic cause of acute pancreatitis (AP).
  
  
  METHODS
  Blood samples from 271 consecutive AP patients, admitted to the Helsinki University Central Hospital emergency unit, were analyzed.
  
  
  RESULTS
  The median (range) disialotransferrin value was significantly higher (P = 0.001) in AP patients with alcoholic (n = 172) 1.6% (0.3%-14.4) than with biliary (n = 60) 0.7% (0.3%-1.3%) or other causes (n = 39) 0.8% (0.3%-4.1%). In receiver operating curve analysis, disialotransferrin, as a single analyte, was significantly (P = 0.001-0.0001) more accurate (area under the curve [AUC], 0.88; 95% confidence interval [CI], 0.84-0.92) in detecting alcoholic AP as compared with glutamyl transferase (AUC, 0.51; 95% CI, 0.45-0.57), aspartate aminotransferase (AUC, 0.57; 95% CI, 0.51-0.63), alanine aminotransferase (AUC, 0.63; 95% CI, 0.57-0.69), erythrocyte mean cell volume (AUC, 0.72; 95% CI, 0.67-0.78), amylase (AUC, 0.74; 95% CI, 0.67-0.78), C-reactive protein (AUC, 0.65; 95% CI, 0.59-0.71), and bilirubin (AUC, 0.55; 95% CI, 0.49-0.62). At a disialotransferrin cutoff of 1.2%, giving an 8% false-positive rate, the positive likelihood ratio was 8.47. Thus, a positive disialotransferrin test result, performed within 24 hours of admission, increased the probability of alcoholic AP from pretest 64% to posttest 94%.
  
  
  CONCLUSIONS
  Disialotransferrin, determined by capillary electrophoresis, is accurate, simple, and a rapid single biomarker of the alcoholic cause of AP.
authors: Research Unit of Substance Abuse Medicine, University of Helsinki, Helsinki, Finland.
authors: Taina
authors: T
authors: Methuen
authors: Leena
authors: L
authors: Kylänpää
authors: Otto
authors: O
authors: Kekäläinen
authors: Toivo
authors: T
authors: Halonen
authors: Eija
authors: E
authors: Tukiainen
authors: Seppo
authors: S
authors: Sarna
authors: Esko
authors: E
authors: Kemppainen
authors: Reijo
authors: R
authors: Haapiainen
authors: Pauli
authors: P
authors: Puolakkainen
authors: Mikko
authors: M
authors: Salaspuro
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000681:Amylases / Q000097:blood; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood; D001660:Biliary Tract Diseases / Q000097:blood / Q000150:complications*; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D003937:Diagnosis, Differential; D019075:Electrophoresis, Capillary / Q000379:methods*; D004909:Erythrocyte Indices; D005189:False Positive Reactions; D005260:Female; D005387:Finland; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D019512:Pancreatitis, Alcoholic / Q000097:blood* / Q000175:diagnosis* / Q000201:enzymology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012795:Sialoglycoproteins / Q000097:blood*; D013997:Time Factors; D014168:Transferrin / Q000031:analogs & derivatives*; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D015415:Biomarkers; D012795:Sialoglycoproteins; D014168:Transferrin; C519691:disialotransferrin; D002097:C-Reactive Protein; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000681:Amylases; D001663:Bilirubin