Monitoring with plasma apolipoprotein A2-isoforms can predict developing new-onset steatotic liver disease caused by pancreatic exocrine insufficiency following pancreatectomy.
Low plasma apoA2-AT/AT after pancreatectomy strongly predicts new-onset steatotic liver disease.
Monitoring with plasma apolipoprotein A2-isoforms can predict developing new-onset steatotic liver disease caused by pancreatic exocrine insufficiency following pancreatectomy.
Development of new-onset steatotic liver disease (steatotic liver disease) has been increasingly observed after pancreatectomy.
This study aimed to clarify the risk factors for new-onset steatotic liver disease after pancreatectomy and verify the utility of monitoring plasma apolipoprotein A2-isoforms (apoA2-i) as a potentially promising biomarker for evaluating pancreatic exocrine function.
In this retrospective study of 79 patients who underwent pancreatectomy [47 pancreaticoduodenectomies (pancreaticoduodenectomies) and 32 distal pancreatectomies (distal pancreatectomies)] between March 2021 and March 2024, the plasma apoA2-i (AT/AT and ATQ/ATQ) levels were measured using enzyme-linked immunosorbent assay (enzyme-linked immunosorbent assay) methods, and non-contrast-enhanced computed tomography (computed tomography) images were manually reviewed for the diagnosis of steatotic liver disease.
low apoA2-AT/AT independently predicts new-onset fatty liver after surgery
Comparing the minimum value of apoA2-AT/AT after surgery between the steatotic liver disease (n=32) and non-steatotic liver disease group (n=47), the apoA2-AT/AT value in the steatotic liver disease group was significantly lower than that in the non-steatotic liver disease group (P<0.001).
Moreover, even when stratified by pre-onset pancrelipase administration, the cumulative incidence of steatotic liver disease was significantly higher in patients with plasma apoA2-AT/AT levels <9.58 µg/mL (P<0.001).
The point estimate of the area under the curve for detecting steatotic liver disease of apoA2-AT/AT was 0.843.
Steatotic liver disease associated with malnutrition following pancreatectomy can be predicted using plasma apoA2-i monitoring.