Enzymatic markers of gallstone-induced pancreatitis identified by ROC curve analysis, discriminant analysis, logistic regression, likelihood ratios, and information theory
| Autor: | Steven C. Kazmierczak, Paul G. Catrou, F Van Lente |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
medicine.medical_specialty
Pancreatic disease biology Biochemistry (medical) Clinical Biochemistry Prevalence Aspartate transaminase medicine.disease Logistic regression Gastroenterology Endocrinology Discriminant function analysis Alanine transaminase Internal medicine biology.protein medicine Acute pancreatitis Pancreatitis |
| Zdroj: | Clinical Chemistry. 41:523-531 |
| ISSN: | 1530-8561 0009-9147 |
| DOI: | 10.1093/clinchem/41.4.523 |
| Popis: | We investigated the diagnostic utility of frequent serial determinations of aspartate aminotransferase, alanine aminotransferase (ALT), lipase, amylase, and the lipase/amylase (L/A) ratio for distinguishing patients with acute pancreatitis due to biliary obstruction from those with acute pancreatitis due to other pathogenesis. Analyzed were enzyme activities obtained at admission and peak enzyme activities identified retrospectively from serial measurements in 53 patients with acute pancreatitis due to various causes. We evaluated the data with multiple statistical tools. Discriminant analysis and logistic regression revealed the diagnostic significance of ALT at initial and peak values, and the maximum information provided by peak ALT was confirmed by both logistic regression and stratum-specific likelihood ratios. Stratum-specific likelihood ratios showed peak ALT > 150 U/L was highly diagnostic of biliary pancreatitis. The L/A ratio, either at admission or at peak, was the only other significant variable for identifying patients with acute pancreatitis due to biliary obstruction. A multivariate logistic discriminant function including ALT and the L/A ratio significantly discriminated biliary acute pancreatitis from pancreatitis due to other causes. Evaluation of initial and peak enzyme data by information theory revealed that the optimal test depended on disease prevalence. Initial ALT activities were the test of choice for identifying biliary pancreatitis, up to a disease prevalence of approximately 0.75. At disease prevalence > 0.75, the initial L/A ratio provided the greatest amount of diagnostic information. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|