Disialotransferrin, determined by capillary electrophoresis, is an accurate biomarker for alcoholic cause of acute pancreatitis.
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.
Methuen
Taina
T
Research Unit of Substance Abuse Medicine, University of Helsinki, Helsinki, Finland.
Kylänpää
Leena
L
Kekäläinen
Otto
O
Halonen
Toivo
T
Tukiainen
Eija
E
Sarna
Seppo
S
Kemppainen
Esko
E
Haapiainen
Reijo
R
Puolakkainen
Pauli
P
Salaspuro
Mikko
M
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
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