The steatocrit as a measure of fecal fat excretion: uses and pitfalls

Pai

et al. 2017

WJG

AIMTo compare two tests for exocrine pancreatic function (EPF) for use in M-ANNHEIM staging for pancreatitis.METHODSOne hundred and ninety four consecutive patients with acute pancreatitis (AP; n = 13), recurrent acute pancreatitis (RAP; n = 65) and chronic pancreatitis (CP; n = 116) were enrolled. EPF was assessed by faecal elastase-1 (FE-1) estimation and stool fat excretion by the acid steatocrit method. Patients were classified as per M-ANNHEIM stages separately based on the results of the two tests for comparison. Independent Student’s t-test, χ2 test, Kruskal-Wallis test, Mann-Whitney U test and McNemar’s test were used as appropriate.RESULTSSixty-one (52.5%) patients with CP had steatorrhoea when assessed by the acid steatocrit method; 79 (68.1%) with CP had exocrine insufficiency by the FE-1 test (χ2 test, P < 0.001). The results of acid steatocrit and FE-1 showed a significant negative correlation (Spearman’s rho = -0.376, P < 0.001). A statistically significant difference was seen between the M-ANNHEIM stages as classified separately by acid steatocrit and the FE-1. Thirteen (6.7%), 87 (44.8%), 89 (45.8%) and 5 (2.5%) patients were placed in M-ANNHEIM stages 0, I, II, and III respectively, with the use of acid steatocrit as against 13 (6.7%), 85 (43.8%), 75 (38.6%), and 21 (10.8%) respectively by FE-1 in stages 0, I, II, and III thereby altering the stage in 28 (14.4%) patients (P < 0.001, McNemar’s test).CONCLUSIONFE-1 estimation performed better than the acid steatocrit test for use in the staging of pancreatitis by the M-ANNHEIM classification since it diagnosed a higher proportion of patients with exocrine insufficiency.

Section: Discussionmentioning

confidence: 99%

Comparing acid steatocrit and faecal elastase estimations for use in M-ANNHEIM staging for pancreatitis

Pai

et al. 2017

WJG

“…Quantification of unabsorbed fats and oils in fecal matter is essential to develop lipase inhibitors and malabsorption drugs. 1 The amount of excreted fat has been measured in various ways in the clinic to diagnose pancreatic diseases and intestinal disorders, as well as in animal studies. 1,2 One method involves titration of the extracted fatty acid; 3 however, this chemical analysis is complicated and time-consuming, and may require the use of harmful chemical materials.…”

Section: Introductionmentioning

confidence: 99%

“…1 The amount of excreted fat has been measured in various ways in the clinic to diagnose pancreatic diseases and intestinal disorders, as well as in animal studies. 1,2 One method involves titration of the extracted fatty acid; 3 however, this chemical analysis is complicated and time-consuming, and may require the use of harmful chemical materials. 2 Another approach is a microscopic examination of fat droplets stained by oil-soluble dyes; 4 however, this method does not provide reliable quantification estimates of the fecal fat.…”

Section: Introductionmentioning

confidence: 99%

A Simple Colorimetric Method to Quantify Total Fecal Oil Using Oil-soluble Dyes in Laboratory Animals and Its Correlation with Liquid Chromatography-Mass Spectrometry Analysis

2018

We developed a colorimetric method for measuring the amount of oil in mouse stool after co-administering an oil-soluble dye. When the amount of oil in the feces calculated from the amounts of Sudan III and Oil Red O was plotted against the amount of oil detected by liquid chromatography-mass spectrometry, the graph was linear, showing a one-to-one correlation between two analyses. This method may be utilized to determine the efficacy of lipase inhibitors, or to assess fat malabsorption in vivo.

Bul. of the Club of Pancr.

“…Однако тест ФЭ1 не может исключить легкую или умеренную ВНПЖ, и отсутствует кон сенсус относительно идеальной градации степени ВНПЖ у пациентов с ХП: предложены показатели <15 мкг/г, 50 мкг/г, 100 мкг/г и 200 мкг/г, но наи более часто для разделения нормы и ВНПЖ приме няют порог 200 мкг/г [16]. Метод кислотного стеа токрита -это количественное измерение жира, выраженное в виде процента от всего центрифугиро ванного образца гомогенизированного стула; он хо рошо коррелирует с количественной оценкой фе кального жира за 72 часа [11]. Однако кислотный стеатокрит имеет некоторые недостатки, которые включают отсутствие стандартизации теста и воз можное влияние количества потребления жира во время сбора образцов [11].…”

unclassified

“…Метод кислотного стеа токрита -это количественное измерение жира, выраженное в виде процента от всего центрифугиро ванного образца гомогенизированного стула; он хо рошо коррелирует с количественной оценкой фе кального жира за 72 часа [11]. Однако кислотный стеатокрит имеет некоторые недостатки, которые включают отсутствие стандартизации теста и воз можное влияние количества потребления жира во время сбора образцов [11].…”

unclassified

Staging chronic pancreatitis with exocrine function tests: are we better?

Sperti

Moletta

2018

Chronic pancreatitis (CP) is an inflammatory disease of the pancreas evolving in progressive fibrotic disruption of the gland with exocrine and endocrine pancreatic insufficiency. Although imaging features of CP are well known, their correlation with exocrine pancreatic function tests are not obvious, particularly in the early stage of the disease. There are many clinical classification of CP, all suggested for better distinguish and manage different forms based on etiological and clinical factors, and severity of the disease. Recently, a new classification of CP has been suggested: the M-ANNHEIM multiple risk factor classification that includes etiology, stage classification and degree of clinical severity. However, more accurate determination of clinical severity of CP requires a correct determination of exocrine function of the pancreas and fecal fat excretion. Recently, Kamath et al. (2017) demonstrated that the evaluation of exocrine pancreatic function by acid steatocrit and fecal elastase-1 (EF-1) was helpful, but EF-1 was able to detect exocrine pancreatic insufficiency in more patients, upgrading some patients in higher stage of disease according to M-ANNHEIM classification. So, EF-1 is a more accurate test to determine exocrine pancreatic insufficiency and to stage chronic pancreatitis in the M-ANNHEIM classification. On the contrary, EF-1 determination shows low sensitivity in detecting exocrine pancreatic insufficiency in early stage of the disease.