Serum Asprosin Concentrations and Severity in Acute Pancreatitis: A Prospective Case–Control Study with Serial Measurements

Background/Objectives: Asprosin is a fasting-induced glucogenic adipokine with pro-inflammatory effects in experimental models, but its behaviour in acute pancreatitis (AP) is unknown. In this exploratory study, we examined whether circulating asprosin differs between patients with AP and healthy controls, how it changes during hospitalisation and whether it is associated with disease severity. Methods: In this prospective case–control study, 82 patients with AP (of 183 screened, after exclusion of diabetes, hypertriglyceridaemia and morbid obesity) and 82 sex-matched healthy controls were enrolled. Serum asprosin was measured by ELISA at admission, 72 h and 120 h in patients and once in fasting controls. Severity was defined by the revised Atlanta classification. Because patients were older and heavier than controls, the group difference was adjusted for age, body mass index and sex and examined in post hoc matched subsamples. Results: Admission asprosin was 4.52 (2.94–5.89) ng/mL in patients and 3.55 (2.24–4.92) ng/mL in controls (p = 0.071); the ratio of geometric means adjusted for age, body mass index and sex was 1.17 (95% CI 0.85–1.61). Asprosin was higher in patients in post hoc age- and sex-matched pairs (median difference 1.91 ng/mL, 95% CI 0.24–3.78) but not in body mass index- and sex-matched pairs (0.96 ng/mL, −0.34 to 2.72). Asprosin changed little over five days and was not associated with moderately severe or severe AP (AUC 0.57, upper 95% confidence limits ≤0.71); only seven patients had severe AP. Conclusions: In this exploratory study, serum asprosin was modestly and non-significantly higher in patients with AP than in controls, and no statistically significant association with severity was detected. Residual confounding by age and body mass index, the exclusion of patients with diabetes or hypertriglyceridaemia (≥200 mg/dL) and the absence of in-house assay validation preclude firm conclusions. These data provide effect estimates for adequately powered, matched studies of asprosin in AP.