Find in Library

Background Mild acute pancreatitis (MAP) has a certain probability of transforming into severe acute pancreatitis (SAP) . Once SAP occurs, it will cause greater harm to patients. It is meaningful for diagnosis and treatment of pancreatitis to explore the transformation mechanism between MAP and SAP. Objective This study aimed to explore the differential metabolites, abnormal metabolic pathways and potential biomarkers between MAP and SAP, thus providing reference for early diagnosis and treatment of SAP. Methods This study collected 68 AP patients who were hospitalized in Hunan Provincial People's Hospital from August 2020 to March 2021. These 68 patients were divided into MAP group (n=40) and SAP group (n=28) based on the 2012 Revised Atlanta Classification (RAC) criteria. This study used liquid chromatography-tandem mass spectrometry (LC-MS) , and screened out the differential metabolites between the two groups by using univariate analysis (T test, FC) , multivariate analysis (PCA, PLS-DA) , VIP>1, FC >1.5, and P<0.05, thus analyzing the differential metabolites and metabolic pathways between the two groups. Results PCA and PLS-DA analyses found that the metabolic profiles of MAP and SAP were significantly different. Combined with VIP>1, FC>1.5, and P<0.05, 50 differential metabolites and 5 metabolic pathways were screened between the two groups, taurine and hypotaurine metabolism, and terpenoid skeleton biosynthesis were the two largest metabolic pathways. Combination with receiver operator characteristic curve (ROC curve) , there were 8 differential metabolites with area under the curve (AUC) >0.9, including 2-phenyl -1, 3-propanediol monocarbamate, diphenhydramine N-glucuronic acid, rac-5, 6-epoxy-retinoyl-β-D-glucuronic acid, hexafluoroisopropanol, NNAL -N-glucuronic acid, erythritol tetranitrate, 3-hydroxybutyric acid, tetrahydrodeoxycorticosterone. Six of them elevated in patients with severe pancreatitis, including 2-phenyl-1, 3-propanediol monocarbamate, rac-5, 6-epoxy-retinoyl-β-D-glucuronic acid, hexafluoroisopropanol, erythritol tetranitrate, 3-hydroxybutyric acid, tetrahydrodeoxycorticosterone. Two of them decreased, including diphenhydramine N-glucuronic acid, NNAL-N-glucuronic acid. Conclusion There were significant differences in serum metabolites between MAP and SAP patients, 2-phenyl-1, 3-propanediol monocarbamate, diphenhydramine N-glucuronic acid, rac-5, 6-epoxy-retinoyl-β-D-glucuronic acid, hexafluoroisopropanol, NNAL-N-glucuronic acid, erythritol tetranitrate, 3-hydroxybutyric acid, and tetrahydrodeoxycorticosterone have the larger differential diagnosis efficacy of MAP and SAP. They may be the potential biomarkers between distinguishing MAP and SAP.