Evaluation of Novel Biochemical Markers for Early Diagnosis and Severity Prediction of Acute Pancreatitis: A Comparative Study in Indian Populations

Introduction: Acute pancreatitis is a serious inflammatory condition affecting the pancreas, and early diagnosis is crucial for prompt treatment and improved patient outcomes. Biochemical markers, substances measured in the blood or other body fluids, play a vital role in the diagnosis and monitoring of acute pancreatitis. This study aimed to evaluate the diagnostic performance of novel biochemical markers in comparison to conventional markers for the early diagnosis of acute pancreatitis in Indian patients. Methods: This prospective, observational, cross-sectional study included 200 participants presenting with acute abdominal pain suggestive of acute pancreatitis at the LPS Institute of Cardiology, Kanpur, Uttar Pradesh, India. Conventional markers (serum amylase and lipase) and novel markers (trypsinogen and interleukin-6) were measured. The diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the curve (AUC), and multivariate logistic regression analysis. Results: The novel biomarker trypsinogen exhibited the highest sensitivity (88.3%) and specificity (80.0%), outperforming conventional markers. Trypsinogen had significantly higher diagnostic accuracy compared to serum amylase (p = 0.011, McNemar's test; p = 0.003, DeLong's test). Higher levels of trypsinogen (OR = 1.04, p < 0.001) and interleukin-6 (OR = 1.02, p = 0.004) were independent predictors of acute pancreatitis diagnosis. Both conventional and novel biomarkers correlated positively with increasing severity of acute pancreatitis (p < 0.001). Conclusion: Novel biochemical markers, particularly trypsinogen, demonstrated superior diagnostic performance compared to conventional markers for the early diagnosis of acute pancreatitis in Indian patients. These findings highlight the potential utility of novel markers in improving diagnostic accuracy and guiding management strategies