title: The potential role of BMI, plasma leptin, nesfatin-1 and ghrelin levels in the early detection of pancreatic necrosis and severe acute pancreatitis: a prospective cohort study.
abstract: BACKGROUND
  Early prediction of disease severity in acute pancreatitis (AP) is crucial. The aim of this study was to investigate the body-mass index (BMI), plasma leptin, nesfatin-1 and ghrelin levels as potential markers predicting peripancreatic necrosis and severity in acute pancreatitis.
  
  
  METHODS
  In the study period, 97 consecutive patients with AP were prospectively analysed. Severe AP was defined according to the Atlanta Criteria. BMI was also calculated. To measure plasma Leptin, Nesfatin-1 and Ghrelin concentrations, the blood samples were obtained from patients within 24 hours of admission.
  
  
  RESULTS
  Out of 97 patients, 92(70 females, 22 males) were considered eligible for analysis. Of the 92 patients, 30 patients (32.6%) were assessed as severe pancreatitis. BMI and leptin levels were significantly higher in patients with severe pancreatitis. The pooled sensitivity and specificity of BMI as a predictor for the development of pancreatic necrosis were 0.90(95%CI = 0.56-0.99) and 0.70(95%CI = 0.58-0.79), respectively; with an overall area under curve value of 0.78.The pooled sensitivity and specificity of leptin levels as a predictor for development of pancreatic necrosis were 1(95%CI = 0.69-1) and 0.73(95%CI = 0.62-0.82),respectively; with an overall area under curve value of 0.82.Nesfatin-1 and ghrelin levels showed no significant difference in patients with mild pancreatitis (6.97 ± 0.84 ng/ml and 2.3(1.0-9.9);respectively) and severe pancreatitis (6.74 ± 0.65 ng/ml and 2.0(1.9-9.9); respectively) (p = 0.1923 and 0.8531;respectively).
  
  
  CONCLUSIONS
  BMI and plasma leptin levels both were correlated with the severity of pancreatitis. Leptin levels showed better area under the curve, sensitivity and specificity values compared to BMI in prediction of pancreatic necrosis.Nesfatin-1 and ghrelin levels were not found to be predictors of the severity of disease.
authors.affiliation: Department of General Surgery, Faculty of Medicine, Dicle University, 21280 Diyarbakır, Turkey. Electronic address: ahmetturkoglu04@hotmail.com.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Türkoğlu
authors.affiliation: Department of General Surgery, Faculty of Medicine, Dicle University, 21280 Diyarbakır, Turkey. Electronic address: azboyuk@hotmail.com.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Böyük
authors.affiliation: Department of Family Medicine, Faculty of Medicine, Dicle University, Turkey. Electronic address: dr.mht@hotmail.com.
authors.forename: Mehmet Halis
authors.initials: MH
authors.lastname: Tanrıverdi
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Dicle University, Turkey. Electronic address: drercangunduz@hotmail.com.
authors.forename: Ercan
authors.initials: E
authors.lastname: Gündüz
authors.affiliation: Department of Radiology, Faculty of Medicine, Dicle University, Turkey. Electronic address: adusak@gmail.com.
authors.forename: Abdurrahim
authors.initials: A
authors.lastname: Dusak
authors.affiliation: Department of Medical Biochemistry, Faculty of Medicine, Dicle University, Turkey. Electronic address: dribrahimkaplan@hotmail.com.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Kaplan
authors.affiliation: Department of General Surgery, Faculty of Medicine, Dicle University, 21280 Diyarbakır, Turkey. Electronic address: metehangumus@yahoo.com.
authors.forename: Metehan
authors.initials: M
authors.lastname: Gümüş
mesh_terms: D000208:Acute Disease; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002135:Calcium-Binding Proteins / Q000097:blood*; D015331:Cohort Studies; D004268:DNA-Binding Proteins / Q000097:blood*; D042241:Early Diagnosis; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D009336:Necrosis / Q000175:diagnosis; D009419:Nerve Tissue Proteins / Q000097:blood*; D000080866:Nucleobindins; D010179:Pancreas / Q000473:pathology*; D010195:Pancreatitis / Q000175:diagnosis*; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D002135:Calcium-Binding Proteins; D004268:DNA-Binding Proteins; D054439:Ghrelin; D020738:Leptin; C000630650:NUCB2 protein, human; D009419:Nerve Tissue Proteins; D000080866:Nucleobindins
keywords: Acute pancreatitis; BMI; Ghrelin; Leptin; Nesfatin-1