Predictive value of serum retinol binding protein in severity and complications of acute pancreatitis: a retrospective cohort study

Abstract

Objectives

Retinol binding protein (RBP) is associated with an increased risk of insulin resistance, metabolic syndrome, atherosclerosis and hypertension. This study aimed to evaluate serum RBP levels in patients with acute pancreatitis (AP).

Methods

The study included 1,871 AP patients, including 1,411 with mild AP (MAP), 244 with moderately severe AP (MSAP), and 186 with severe AP (SAP). Retrospective analysis was conducted on RBP concentrations and other clinical data of AP patients.

Results

AP patients were subgrouped by RBP level into low RBP (LRBP), normal RBP (NRBP), and high RBP (HRBP) groups. The LRBP group showed a significantly higher proportion of SAP patients than NRBP and HRBP groups. Additionally, the LRBP group had the highest BISAP and CTSI scores among the three groups; WBC and CRP levels in the NRBP group were significantly lower than those in the LRBP and HRBP groups. RBP was better at predicting acute necrotic collection (ANC) than other local complications, with an area under the curve (AUC) of 0.821. RBP was also an independent risk factor for acute lung injury (ALI) and ANC in AP patients. The AUC of RBP for predicting ALI was 0.829, with 30.45 mg/L as the optimal cutoff value, and the sensitivity and specificity were 59.70% and 96.50%, respectively. The AUC of RBP for predicting ANC was 0.821, with 28.35 mg/L as the optimal cutoff value, and the sensitivity and specificity were 61.20% and 95.50%, respectively.

Conclusions

Serum RBP had predictive value for AP severity, local and systemic complications.

Keywords:

• Acute pancreatitis
• retinol binding protein
• severity
• acute lung injury
• acute necrotic collection

Acknowledgments

We thank all the AP patients included in the study and their families and the staff of Shanghai General Hospital to take care of the AP patients.

Author contributions

Concept and design: XH and CYC; data acquisition, analysis, or interpretation: JBN, BL and JPB; statistical analysis: XH, BL and JPB; funding acquisition: XH, CYC and GYH; supervision: RW and GYH; manuscript preparation, editing, and review: All authors.

Disclosure statement

The authors declared no conflict of interest.

Additional information

Funding

This work was supported by grants from the National Natural Science Foundation of China (No.81900584, XH; No.81800566, CYC), Shanghai Health Commission’s Clinical Research Project in the Health Industry (No.20224Y0249, CYC) and Key Support Project of Clinical Research (Shanghai Shenkang Hospital Development Center, No. SHDC2020CR5013, GYH).