Serum REG1A protein is a biomarker for diagnosis and progression prediction of pancreatitis

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BACKGROUND: Serum regenerating islet-derived protein 1 alpha (REG1A), a protein associated with pancreatic inflammation, is emerging as a potential biomarker for pancreatitis. This case-control study aimed to evaluate the diagnostic and prognostic value of REG1A in patients with acute pancreatitis (AP) and chronic pancreatitis (CP). METHODS: A total of 349 participants were recruited prospectively from two centers, including healthy controls (n = 70), AP (n = 169), and CP (n = 110). Serum REG1A levels were measured, and diagnostic performance was assessed. The correlations of REG1A with disease progression were evaluated using univariate and multivariate logistic regression analyses. RESULTS: Serum REG1A levels were significantly elevated in both AP and CP patients compared to controls. REG1A demonstrated high accuracy for distinguishing AP and CP from controls (Area under the curve (AUC): 0.914 and 0.875, respectively). In AP, REG1A levels increased with disease severity (P < 0.001) and demonstrated moderate diagnostic performance for severe AP with an AUC of 0.750 (95% CI: 0.671-0.828). REG1A outperformed C-reactive protein (CRP) and procalcitonin (PCT) as an independent predictor of severe AP (OR = 1.058 per 10 ng/ml; 95% CI, 1.022-1.094, P = 0.001). In CP, REG1A levels correlated positively with disease stages (r = 0.309, P < 0.001) and remained an independent predictor of pancreatic insufficiency (OR = 1.089 per 10 ng/ml, 95% CI, 1.010-1.174, P = 0.027). REG1A had a moderate diagnostic accuracy for distinguishing CP patients with pancreatic insufficiency from those without with an AUC of 0.700 (95% CI: 0.600-0.800). CONCLUSIONS: Serum REG1A is a promising biomarker for diagnosing pancreatitis, and predicting both AP severity and CP progression. These findings underscore the potential role of REG1A in the diagnosis and management of pancreatitis.

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