Spexin as a Novel Biomarker for Predicting Disease Severity and Mortality in Acute Pancreatitis

This study aimed to investigate the diagnostic and prognostic value of serum spexin levels in patients with acute pancreatitis (AP) and to assess their association with disease severity and mortality. A total of 34 AP patients and 34 healthy individuals were included in the study. AP patients were classified into three groups: mild, moderately severe, and severe (SAP). Serum spexin levels were measured using ELISA, and biochemical parameters, inflammatory indices, and clinical scores were compared. Univariate logistic regression analysis was performed to evaluate factors associated with AP severity and mortality, and ROC analysis was used to assess the diagnostic performance. The median spexin level in AP patients was significantly higher than in healthy controls (<i>p</i> < 0.001). Spexin levels increased markedly in SAP patients and were highest in non-survivors (<i>p</i> < 0.001). In univariate analysis, higher spexin levels were associated with SAP (OR: 4.116, 95% CI: 1.348-12.572; <i>p</i> = 0.013) and 28-day mortality (OR: 3.132, 95% CI: 1.316-7.453; <i>p</i> = 0.010). ROC analyses suggested favorable diagnostic performance of spexin; however, given the exploratory design and small sample size, the findings should be interpreted with caution. Spexin may serve as a complementary early-phase biomarker for risk stratification.