Urinary amylase levels in the diagnosis of acute pancreatitis: a prospective case control study

Abstract

Background: Serum amylase has a short biological half-life and returns to normal levels within short time. Thus it’s quite conflicting in the diagnosis of acute pancreatitis, particularly in patients with mild acute pancreatitis. Therefore, present study investigates the urinary amylase levels in the diagnosis of acute pancreatitis.Methods: The present prospective study was conducted on 100 patients, 50 with acute pancreatitis and 50 normal subjects in the departments of General Surgery and our surgical hospital. All patients were examined by clinically, biochemical and radiological investigations and diagnosed acute pancreatitis. Serum amylase levels, serum lipase levels and urinary amylase levels were estimated in both groups: cases and controls. The sensitivity and specificity of serum amylase, serum lipase and urinary amylase levels were established after comparing their values in cases and controls.Results: The preponderance of the patients was aged between 21 and 50 years. Increase the serum amylase, lipase and urinary amylase mean values of patients with acute pancreatitis were observed statistically significant (p<0.001). Serum amylase had the highest sensitivity (100%) and serum lipase had the highest specificity (96.53%). The sensitivity and specificity of urinary amylase was found to be 97.25% and 91.47% respectively. On ROC curve analysis, the area under the curve for serum amylase, serum lipase and urinary amylase was found to be 0.845, 0.945 and 0.934.Conclusions: We conclude that urinary amylase is a convenient and a more sensitive test for diagnosis of acute pancreatitis.