The Predictive Value of Gut Metabolite Levels for Myocardial Injury and Prognosis in Patients with Acute Pancreatitis

Shihao JIA; Kejing YU; Manhe ZHANG; Fumei ZHANG; Jingcha HAO

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Article Navigation > Journal of Kunming Medical University > 2025 > Accepted Manuscript

Shihao JIA, Kejing YU, Manhe ZHANG, Fumei ZHANG, Jingcha HAO. The Predictive Value of Gut Metabolite Levels for Myocardial Injury and Prognosis in Patients with Acute Pancreatitis[J]. Journal of Kunming Medical University.

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The Predictive Value of Gut Metabolite Levels for Myocardial Injury and Prognosis in Patients with Acute Pancreatitis

1.
Emergency Department，Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine，Cangzhou Hebei 061001
2.
Department of Function，Yanshan People’s Hospital，Cangzhou Hebei 061300
3.
Emergency Department，Yanshan County People’s Hospital，Cangzhou Hebei 061300，China

Received Date: 2025-06-24
Available Online: 2025-09-16

Abstract

Abstract

Objective To investigate the value of gut metabolites in predicting the development of severe acute pancreatitis （SAP）, myocardial injury, and adverse outcomes in patients with acute pancreatitis （AP）. Methods A total of 80 SAP patients admitted to Cangzhou Hospital of Integrated Chinese and Western Medicine from April 2023 to April 2024 were selected as the severe group, and 80 non-severe AP patients were selected as the non-severe group. The levels of serum amylase, lipase, acetic acid, propionic acid, butyric acid, and total short-chain fatty acids （SCFAs） in feces, serum bile acid （BA）, trimethylamine n-oxide （TMAO）, myocardial injury-related indicators [creatine kinase isoenzymes （CK-MB）, cardiac troponin T （cTnT）, N-terminal pro-b-type natriuretic peptide （NT-proBNP）], C-reactive protein （CRP）, acute physiology and chronic health evaluation II （APACHE II） and bedside index for severity in acute pancreatitis （BISAP） were compared between the two groups at admission. Patients in the severe group were followed up for 30 days and divided into a survival subgroup （n = 61） and a non-survival subgroup （n = 19） based on their prognosis. The levels of total SCFAs, BA, and TMAO were compared between these two subgroups. Spearman correlation analysis was used to analyze the correlation of serum amylase, lipase, total SCFAs, BA, and TMAO levels with myocardial injury-related indicators and disease severity scores in all patients. Multivariate logistic regression analysis was used to identify the influencing factors for the occurrence of SAP. Receiver operating characteristic （ROC） curve analysis was used to evaluate the predictive value of total SCFAs, BA, TMAO, and their combination for the occurrence of SAP. Results Compared with the non-severe group, the severe group had significantly lower levels of acetic acid, propionic acid, butyric acid, and total SCFAs （P < 0.01）, and significantly higher levels of BA, TMAO, CK-MB, cTnT, NT-proBNP, CRP, and APACHE II and BISAP scores. Within the severe group, the non-survival subgroup had significantly lower levels of total SCFAs （P < 0.05） and significantly higher levels of BA and TMAO （P < 0.05） compared to the survival subgroup. Spearman analysis showed that the levels of CK-MB, cTnT, NT-proBNP, CRP, and the APACHE II and BISAP scores were negatively correlated with total SCFAs levels and positively correlated with BA and TMAO levels （P < 0.001）. Multivariate logistic regression analysis revealed that total SCFAs, BA, and TMAO were independent influencing factors for the occurrence of SAP （P < 0.05）. ROC curve analysis showed that the area under the curve （AUC） for total SCFAs, BA, TMAO, and their combination in predicting the occurrence of SAP were 0.951, 0.797, 0.790, and 0.974, respectively （P < 0.001）. The AUC for the combination of the three markers was larger than that of any single marker, indicating good predictive efficacy. Conclusion The levels of gut metabolites SCFAs, BA, and TMAO in SAP patients are independent factors associated with myocardial injury and prognosis.
- Severe acute pancreatitis,
- Gut metabolites,
- Myocardial injury,
- Prognosis

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