Untargeted Metabolomics for the Diagnosis of Exocrine Pancreatic Insufficiency in Chronic Pancreatitis

• Main Authors: Caridad Díaz, Cristina Jiménez-Luna, Carmelo Diéguez-Castillo, Ariadna Martín, José Prados, José Luis Martín-Ruíz, Olga Genilloud, Francisca Vicente, José Pérez del Palacio, Octavio Caba
• Format: Article
• Language: English
• Published: MDPI AG 2021-08-01
• Series: Medicina
• Subjects: metabolomics; exocrine pancreatic insufficiency; chronic pancreatitis; biomarker; diagnosis; high-resolution mass spectrometry
• Online Access: https://www.mdpi.com/1648-9144/57/9/876

<i>Background and Objectives</i>: The clinical manifestations and course of chronic pancreatitis (CP) are often nonspecific and variable, hampering diagnosis of the risk of exocrine pancreatic insufficiency (EPI). Development of new, reproducible, and non-invasive methods to diagnose EPI is therefore a major priority. The objective of this metabolomic study was to identify novel biomarkers associated with EPI. <i>Materials and Methods</i>: We analyzed 53 samples from patients with CP, 32 with and 21 without EPI, using an untargeted metabolomics workflow based on hydrophilic interaction chromatography coupled to high-resolution mass spectrometry. Principal component and partial least squares-discriminant analyses showed significant between-group differentiation, and univariate and multivariate analyses identified potential candidate metabolites that significantly differed between samples from CP patients with EPI and those without EPI. <i>Results</i>: Excellent results were obtained using a six-metabolic panel to diagnose the presence of EPI in CP patients (area under the ROC curve = 0.785). <i>Conclusions</i>: This study confirms the usefulness of metabolomics in this disease setting, allowing the identification of novel biomarkers to differentiate between the presence and absence of EPI in CP patients.