Value of serum PABA as a pancreatic function test.

Abstract

SUMMARY In a total of 71 subjects (19 controls, 24 patients with non-pancreatic gastrointestinal disease, and 27 patients with pancreatic disease) an oral pancreatic function test using N-benzoyl-L-tyrosyl-PABA (BT-PABA) was performed with simultaneous determination of the serum para-aminobenzoic acid (PABA). Urinary excretion of PABA was significantly less (p<OOOl) in patients with chronic pancreatitis (n= 12) and pancreatic carcinoma (n= 10) than in controls and in patients with non-pancreatic disease. The serum concentration curve in patients with chronic pancreatitis was significantly flattened (p<0001) compared with that of the control group and the patients with non-pancreatic gastrointestinal disease. The discrimination between the controls and the patients with chronic pancreatitis was best at 120 minutes after administration of BT-PABA (lower limit of normal: 28 ,ug/ml). The results of our study show that determination of PABA serum concentration two hours after administration of BT-PABA is as valuable an index of pancreatic function as the urinary excretion of PABA.The oral pancreatic function test using N-benzoyl-Ltyrosyl-para-aminobenzoic acid (BT-PABA) has proved to be a simple and reliable test in detecting moderate to severe exocrine pancreatic insufficiency. In over 900 patients and controls tested we found a sensitivity of 85% for chronic pancreatitis and a specificity of 90%, which correlates well with the data from other European studies.1-5 In our experience, however, the value of the test depends to a large extent on a correctly conducted urinary collection. In some patients, particularly in elderly, severe debilitated patients, those with urological disorders, and in children, an inaccurate collection of urine will invalidate the results of the test.It has recently become possible to measure the PABA in the serum after administration of BT-PABA. The serum concentration profile of PABA in patients with exocrine pancreatic insufficiency was shown to be significantly lower than that found in healthy controls.i8 The data are, however, too few to allow any conclusion on the value of the procedure; and furthermore, methodology of pancreatic function test used in the studies varied from one group of investigators to another. Determination of PABA in the serum instead of urine could represent an alternative pancreatic

Three-Year Observation of Glucose Metabolism After Pancreaticoduodenectomy: A Single-Center Prospective Study in Japan

“…As an index of insulin sensitivity, homeostasis model assessment of insulin resistance (HOMA-IR) values were derived using the following equation: (fasting insulin [μIU/mL] × fasting glucose [mmol/L])/22.5. Exocrine function was assessed using the BT-PABA test ( 28 ), which was orally administered, and the urinary PABA excretion rate was measured 6 hours after dosage.…”

Glucose Metabolism After Pancreatectomy: Opposite Extremes Between Pancreaticoduodenectomy and Distal Pancreatectomy

“…As an index of insulin sensitivity, the homeostasis model assessment of insulin resistance (HOMA-IR) value was calculated using the following formula: (fasting insulin [µIU/mL] × fasting glucose [mmol/L])/22.5. Exocrine function was assessed using the BT-PABA test ( 18 ). BT-PABA was administered orally, and the rate of urinary PABA excretion was determined 6 hours after administration.…”

Quantification of pancreatic zinc output as pancreatic function test: Making the secretin-caerulein test applicable to clinical practice

“…The disadvantages of being complex, invasive, and expensive have limited the use of this test to some highly specialized centres. Because of that, we and other researchers have been investigating over the last years methods which are non-invasive and convenient [23][24][25][26][27][28]. All these non-invasive methods have, however, limited sensitivity and specificity, and thus the SCT remains the gold standard for evaluation of the exocrine pancreatic function.…”