Apolipoprotein A2 isoforms associated with exocrine pancreatic insufficiency in early chronic pancreatitis

• Published in: Journal of gastroenterology and hepatology Vol. 38; no. 11; pp. 1949 - 1957
• Main Authors: Futagami, Seiji, Agawa, Shuhei, Nakamura, Ken, Watanabe, Yoshiyuki, Habiro, Mayu, Kawawa, Rie, Yamawaki, Hiroshi, Tsushima, Rina, Kirita, Kumiko, Akimoto, Teppei, Ueki, Nobue, Tomohide, Tanabe, Itokawa, Norio, Suzuki, Nami, Naito, Yutaka, Takeuchi, Keiko, Kashiro, Ayumi, Ohta, Ryu, Mizutani, Satoshi, Taniai, Nobuhiko, Yoshida, Hiroshi, Iwakiri, Katsuhiko, Honda, Kazufumi
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01-11-2023
• Subjects: apolipoprotein A2; Apolipoproteins; Body mass index; Dyspepsia; early chronic pancreatitis; Endoscopy; endosonography; Enzymes; exocrine pancreatic dysfunction; exocrine pancreatic insufficiency (EPI); functional dyspepsia with pancreatic enzyme abnormalities; Isoforms; Pancreatic cancer; Pancreatitis; Ultrasonic imaging; exocrine pancreatic insufficiency (EPI); exocrine pancreatic dysfunction; functional dyspepsia with pancreatic enzyme abnormalities; early chronic pancreatitis; endosonography; apolipoprotein A2
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.16302

Background and Aim
Apolipoprotein A2 (apoA2) isoforms have been reported to undergo the aberrant processing in pancreatic cancer and pancreatic risk populations compared with that in healthy subjects. This study aimed to clarify whether apoA2 isoforms were as useful as N‐benzoyl‐p‐aminobenzoic acid (BT‐PABA) test for exocrine pancreatic dysfunction markers in patients with early chronic pancreatitis (ECP).
Methods
Fifty consecutive patients with functional dyspepsia with pancreatic enzyme abnormalities (FD‐P) (n = 18), with ECP (n = 20), and asymptomatic patients with pancreatic enzyme abnormalities (AP‐P) (n = 12) based on the Rome IV classification and the Japan Pancreatic Association were enrolled in this study. The enrolled patients were evaluated using endoscopic ultrasonography and endoscopic ultrasonography elastography. Five pancreatic enzymes were estimated. Pancreatic exocrine function was analyzed using the BT‐PABA test. Lighter and heavier apoA2 isoforms, AT and ATQ levels were measured by enzyme‐linked immunosorbent assay methods.
Results
There were no significant differences in clinical characteristics such as age, gender, body mass index, alcohol consumption and smoking among patients with AP‐P, FD‐P, and ECP. The BT‐PABA test and lighter apoA2 isoform, AT level in the enrolled patients had a significant correlation (P < 0.01). The BT‐PABA test in patients with ECP was significantly lower (P = 0.04) than that in AP‐P. ApoA2‐AT level in patients with ECP was lower than that in AP‐P, albeit, insignificantly. Interestingly, apo A2‐AT level was significantly (P = 0.041) associated with exocrine pancreatic insufficiency by multiple logistic regression analysis.
Conclusions
ApoA2‐AT level is a useful tool to evaluate exocrine pancreatic insufficiency in the early stage of chronic pancreatitis.