Diagnostic and clinical relevance of targeted metabolomic analysis of serum bile acid profiles in acute pancreatitis.

OBJECTIVE

This study aims to identify specific bile acids with potential early diagnostic value for acute pancreatitis (AP) and to provide a foundation for improved early diagnosis and the development of future therapeutic targets.

METHODS

Targeted quantitative analysis of serum bile acids was performed using ultra-performance liquid chromatography coupled with high-resolution mass spectrometry in healthy individuals and individuals diagnosed with mild acute pancreatitis (MAP), moderate-to-severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP). Comparative analysis of bile acid profiles was conducted across these groups. The diagnostic performance of differential metabolic markers was evaluated using receiver operating characteristic curve analysis. Additionally, correlation heatmap analysis was employed to investigate associations between specific bile acids and clinical laboratory parameters.

RESULTS

Fourteen specific bile acids were identified. Taurocholic acid (TCA) was determined to be a distinguishing metabolite between the MSAP group and the healthy control group. Furthermore, taurochenodeoxycholic acid (TCDCA), glycocholic acid, taurodeoxycholic acid, and TCA were identified as differential metabolites between the SAP group and the healthy control group. Correlation analysis demonstrated that in the MSAP group, TCDCA exhibited a positive association with serum glucose, taurolithocholic acid (TLCA), serum triglycerides, cholic acid, and serum total cholesterol. In the SAP group, positive correlations were observed among TLCA, glycochenodeoxycholic acid, and serum calcium, between glycodeoxycholic acid (GDCA), chenodeoxycholic acid, and urine amylase, as well as between GDCA and serum lipase.

CONCLUSION

Specific serum bile acids, particularly TCA and TCDCA, demonstrate potential as biomarkers for the early, non-invasive, and accurate diagnosis of MSAP and SAP. These findings contribute to the advancement of early diagnostic strategies for acute pancreatitis.