Changes in plasma levels of homocysteine in patients with acute pancreatitis.

The role of homocysteine role in inflammation and malignancy has been studied experimentally. Some researchers suggest that a relationship exists between pancreatitis and homocystinuria, possibly being secondary to occlusive vascular disease of the pancreas. To date, plasma homocysteine levels in pancreatic disease have not been studied. We aimed to analyze the homocysteine status in patients with acute pancreatitis, and the changes of the plasma homocysteine level at the acute phase of the disease and six months after hospital discharge. Fourteen acute pancreatitis patients and 14 healthy subjects were studied. Plasma homocysteine, vitamin B12, folate, amylase, lipase, C-reactive protein, total, HDL and LDL cholesterol, triglycerides, blood urea nitrogen, white blood cells, and creatinine were measured in the two groups of subjects. Plasma levels of homocysteine were significantly higher in patients with acute pancreatitis as were serum creatinine, blood urea nitrogen, WBC counts, amylase, lipase, and C-reactive protein. An impaired creatinine clearance was also found in these patients but this did not reach statistical significance. Serum total, HDL, and LDL cholesterol concentrations were not significantly different between the two groups of subjects. Our data suggest that homocysteine may play a role in inflammatory diseases of the pancreas. Increased plasma homocysteine levels in acute pancreatitis may be a reason, or a marker, for the diagnosis of acute pancreatitis. In conclusion, this is the first report showing that patients with acute pancreatitis have higher plasma homocysteine levels than healthy subjects.