title: Urinary amylase/urinary creatinine ratio (uAm/uCr)--a less-invasive parameter for management of hyperamylasemia.
abstract: BACKGROUND
  The serum level of amylase (sAm) is commonly used as a biochemical marker for diagnosis and management of pancreatic disorders. However, the use of the urine level of amylase (uAm) is limited in practice, because the diagnostic ability of uAm is inferior to that of sAm. In the present study, the possible concordance of uAm-rerated parameters with sAm was investigated, and evaluate the usefulness of uAm for management of hyperamylasemia.
  
  
  METHODS
  From June 1995 to October 2009, 804 samples of both urine and blood were collected from 128 patients in order to measure the serum level of amylase (sAm) and the urine level of amylase (uAm) and creatinine (uCr). Concordance of parameters using uAm compared to sAm was assessed. Parameters used were uAm, amylase creatinine clearance ratio (ACCR), and the ratio of uAm to uCr (uAm/uCr).
  
  
  RESULTS
  uAm/uCr had the best correlation with sAm (r = 0.779, p < 0.001) compared to uAm (r = 0.620, p < 0.001) and to ACCR (r = 0.374, p < 0.001), when sAm was over the standard level. The area under the receiver operating characteristic curve of uAm/uCr (0.884) was significantly higher than that of uAm (0.766) and of ACCR (0.666) (p < 0.001 for each). The cutoff value of uAm/uCr was 569.8, with a sensitivity of 81.0% and a specificity of 83.1%.
  
  
  CONCLUSIONS
  The uAm/uCr ratio correlated with sAm, and may be an alternative to sAm for prediction of hyperamylasemia. Use of urine samples results in a decreased need for blood sampling, which is especially beneficial in pediatric patients.
authors: Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Japan. kta@cc.rim.or.jp.
authors: Keita
authors: K
authors: Terui
authors: Tomoro
authors: T
authors: Hishiki
authors: Takeshi
authors: T
authors: Saito
authors: Tetsuya
authors: T
authors: Mitsunaga
authors: Mitsuyuki
authors: M
authors: Nakata
authors: Hideo
authors: H
authors: Yoshida
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000652:urine; D000681:Amylases / Q000097:blood / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D002648:Child; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000150:complications / Q000652:urine; D003404:Creatinine / Q000652:urine*; D003953:Diagnosis-Related Groups; D005260:Female; D006801:Humans; D034321:Hyperamylasemia / Q000209:etiology / Q000628:therapy / Q000652:urine*; D007223:Infant; D008297:Male; D010195:Pancreatitis / Q000150:complications / Q000652:urine; D012189:Retrospective Studies; D015983:Selection Bias; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003404:Creatinine; D000681:Amylases