Increased circulating total bile acid levels were associated with organ failure in patients with acute pancreatitis

Abstract

Background: Recent studies have shown that bile acids (BAs) are closely related to metabolic and inflammatory diseases. Our study aimed to investigate whether circulating total bile acid (TBA) levels were associated with the severity of acute pancreatitis (AP). Methods: We retrospectively collected data on patients diagnosed with AP in a tertiary center from 01 January 2014 to 31 December 2016. The highest TBA value during the first 1,2,3,5,7 days after admission was determined as D1, D2, D3, D5, D7 TBA max. Patients were divided into the high TBA (HTBA) group and the normal TBA (NTBA) group according to whether the TBA max was ≥10 μmol/L. The prognosis and complications, including death, organ failure (OF) and pancreatic necrosis, were compared between the two groups. Logistic regression analysis and receiving operating characteristic (ROC) curve were used to evaluate the relationship between circulating TBA and organ failure in AP patients. Results: Through stratified analysis of each time period, we found that the incidence of OF in the HTBA group was significantly higher than that in the NTBA group, and the AP severity classification in the HTBA group was more serious than that in the NTBA group. In addition, according to the D7 TBA max values, the pancreatic necrosis rate, percutaneous catheter drainage (PCD) rate and mortality in the HTBA group were higher than those in the NTBA group. Multivariate regression analysis showed that HTBA (odds ratio (OR), 4.894; P = 0.002) was an independent risk factor for AP complicated with OF, which was verified in the grouping based on D7 TBA max. ROC analysis revealed that a circulating D7 TBA max cutoff point of 6.450 umol/L had optimal predictive value for the development of OF in AP patients with an area under the curve of the ROC curve (AUCROC) of 0.777. Conclusions: The increase of circulating TBA in early stage of AP is independently related to organ failure, which indicates the adverse prognosis of AP patients.

The bacterial metabolite, lithocholic acid, has antineoplastic effects in pancreatic adenocarcinoma

“…Bile acids are associated with risk factors of pancreatic adenocarcinoma, such as obesity, diabetes, pancreatitis, and hypertriglyceridemia. For example, the concentration of DCA is elevated in type 2 diabetes [92], ob/ob mice have elevated plasma bile acid levels [93], and circulating total bile acid levels are increased in pancreatitis [94].…”

Mean Corpuscular Hemoglobin Predicts Length of Hospital Stay Independent of Severity Classification in Acute Pancreatitis Patients: a Retrospective Study

“…Total cholesterol concentration predicts the effect of plasmapheresis on hypertriglyceridemic AP 8 . Increased circulating total bile acid levels were associated with organ failure in patients with AP 9 . There are no studies investigating e cacy of MCH, MCV, MCHC, HGB or RBC in predicting length of hospital stay of AP.…”

Bile Acids and Microbiota Interplay in Pancreatic Cancer

“…Therefore, the disease-exacerbating effect of BAs would not only require reflux into the pancreatic duct but could be elicited by serum or interstitial BAs in jaundice patients [85]. In addition, systemically circulating BAs also contributed to organ failure in pancreatitis patients [86]. Furthermore, a recent study in mice suggested a strong association between chronic pancreatitis and gut microbiota [87].…”