Urinary Amylase as the First Line Diagnostic Tool for Acute Pancreatitis

Abstract

Background: Diagnosis of acute pancreatitis is based on raised serum lipase and serum amylase in the blood. However, the levels of urinary amylase can be sought for being less invasive. The study aimed to find out the diagnostic accuracy of urinary amylase compared to serum amylase and serum lipase and their association with the degree of severity of acute pancreatitis. Methods: A randomized clinical control study was conducted on n=180 acute pancreatitis patients (18-50 year) in the Ziauddin and PNS Shifa Hospital, Karachi from September 2019- August 2020. Serum amylase, serum lipase and urinary amylase levels were checked at the time of admission followed by 24 hours and at discharge. ANOVA with post-hoc Tuckey’s test was used to determine the association of amylases with the severity of acute pancreatitis and p˂0.05 was considered as statistically significant. Results: The patients with acute pancreatitis had a mean age of 51.76 ±10.8. Urinary amylase had a strong significant association (p˂0.05) with acute pancreatitis compared to serum amylase and lipase (p=0.024). There was an insignificant association of urinary amylase with acute pancreatitis after 24 hours. Similarly, urinary amylase reported good diagnostic discrimination of acute pancreatitis as the accuracy index, the area under the ROC curve was one, showing higher sensitivity and specificity by covering the maximum population under the ROC curve. Conclusion: The significance of Urinary amylase (p˂0.05) was higher than serum amylase, serum lipase because of sensitivity and specificity for diagnosing acute pancreatitis representing a positive association with the degree of severity of the disease. Keywords: Acute Pancreatitis; Amylase; Lipase; Amylase.