Elevated serum neopterin concentration increases mortality risk in patients with acute pancreatitis

Abstract

Background The aim of this study was to investigate serum neopterin levels in patients with acute pancreatitis (AP) and its predictive value for mortality in cases of severe acute pancreatitis (SAP). Methods Eighty-two patients with confirmed acute pancreatitis (AP) were included and divided into two groups, mild acute pancreatitis (MAP, n=51) and severe acute pancreatitis (SAP, n=31) according to severity of disease. From the SAP group, 8 cases went on to develop multiple organ dysfunction syndrome (MODS) and 6 subsequently died. Thirty healthy subjects from routine medical examination were included as the control group. The neopterin serum concentrations were determined and compared between groups. Results Serum neopterin concentrations from control, MAP, SAP, SAP-Non-MODS, MODS-survival and MODS-death groups were 6.85±2.42 (nmol/L), 0.91±4.83(nmol/L), 33.11±11.67(nmol/L), 30.39±9.97(nmol/L), 36.40±4.48(nmol/L) and 41.75±15.64(nmol/L) respectively, with statistical significant difference (p<0.05). The sensitivity and specificity for mortality risk were 66.67% (95%CI:22.28-95.67%) and 88.00%(95%CI:68.78-97.45%) respectively, with area under the ROC curve (AUC) of 0.71(95%CI:0.50-0.9), under the cut off value of 40.18. Conclusion: Serum neopterin levels in patients with acute pancreatitis were significantly elevated and correlated with the severity of disease. Neopterin may also be used a serological biomarker of mortality risk in patients with SAP.