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Post-ERCP Pancreatitis and Serum Asprosin: A Potential Marker Associated with Beta Cell Damage

Year 2025, Volume: 78 Issue: 3, 245 - 257, 30.09.2025
https://doi.org/10.65092/autfm.1747924

Abstract

Aim: Asprosin is a protein produced by adipose tissue that has a significant function in regulating glucose metabolism. Inflammation in pancreatitis leads to beta cell damage and deterioration of beta cell functions. Recent studies have shown a relationship between asprosin and pancreatic beta cell damage. This research aimed to examine the association between pancreatitis developing after endoscopic retrograde cholangiopancreatography (ERCP) and asprosin levels, which is also considered an indicator of beta cell damage.
Materials and Methods: The study was conducted with 25 patients who developed pancreatitis after ERCP and 21 participants as a control group at Ankara Bilkent City Hospital. Acute pancreatitis was diagnosed through correlation of clinical, imaging, and laboratory findings. In addition, the post-ERCP pancreatitis group was classified as “mild” and “moderate-severe” according to disease severity, and asprosin levels were compared between the groups. Correlations between asprosin and biochemical and hematological parameters were analyzed.
Results: Serum asprosin concentrations were elevated in the post-ERCP pancreatitis group (p < 0,001). Amylase, lipase, GGT, AST, total and direct bilirubin levels also increased significantly in the pancreatitis group. In the pancreatitis group, a negative correlation was observed between asprosin levels and leukocyte (r = -0.433; p = 0.031) and lymphocyte counts (r = -0.440; p = 0.028). No meaningful correlation was observed between asprosin concentrations and the severity of pancreatitis (p = 0,347).
Conclusion: In patients with post-ERCP pancreatitis, asprosin levels are increased, which could potentially be associated with the inflammatory response. However, asprosin does not seem to directly reflect disease severity. Therefore, asprosin can be considered as a new biomarker candidate associated with pancreatic beta cell damage and inflammation; however, Additional research is required to elucidate its diagnostic and prognostic role.

References

  • Zerem E. Treatment of severe acute pancreatitis and its complications. World J Gastroenterol. 2014;20(38):13879-13892.
  • Krishna SG, Kamboj AK, Hart PA, Hinton A, Conwell DL. The Changing Epidemiology of Acute Pancreatitis Hospitalizations: A Decade of Trends and the Impact of Chronic Pancreatitis. Pancreas. 2017;46(4):482-488.
  • Vonderau JS, Desai CS. Type 3c: Understanding pancreatogenic diabetes. JAAPA. 2022;35(11):20-24.
  • Wynne K, Devereaux B, Dornhorst A. Diabetes of the exocrine pancreas. J Gastroenterol Hepatol. 2019;34(2):346-354.
  • Romere C, Duerrschmid C, Bournat J, Constable P, Jain M, Xia F et al. Asprosin, a Fasting-Induced Glucogenic Protein Hormone. Cell. 2016;165(3):566-579.
  • Diao H, Li X, Xu Y, Xing X, Pang S. Asprosin, a novel glucogenic adipokine implicated in type 2 diabetes mellitus. J Diabetes Complications. 2023;37(11):108614.
  • Nam H, Hong SS, Jung KH, Kang S, Park MS, Kang S, et al. A Serum Marker for Early Pancreatic Cancer With a Possible Link to Diabetes. J Natl Cancer Inst. 2022;114(2):228-234.
  • Wang R, Hu W. Asprosin promotes β-cell apoptosis by inhibiting the autophagy of β-cell via AMPK-mTOR pathway. J Cell Physiol. 2021;236(1):215-221.
  • Lee T, Yun S, Jeong JH, Jung TW. Asprosin impairs insulin secretion in response to glucose and viability through TLR4/JNK-mediated inflammation. Mol Cell Endocrinol. 2019;486:96-104.
  • Yuan M, Li W, Zhu Y, Yu B, Wu J. Asprosin: A Novel Player in Metabolic Diseases. Front Endocrinol (Lausanne). 2020;11:64.
  • Cozma MA, Angelescu C, Haidar A, Mateescu RB, Diaconu CC. Incidence, Risk Factors, and Prevention Strategies for Post-ERCP Pancreatitis in Patients with Biliopancreatic Disorders and Acute Cholangitis: A Study from a Romanian Tertiary Hospital. Biomedicines. 2025;13(3):727.
  • Morales SJ, Sampath K, Gardner TB. A Review of Prevention of Post-ERCP Pancreatitis. Gastroenterol Hepatol (N Y). 2018;14(5):286-292.
  • Cahyadi O, Tehami N, de-Madaria E, Siau K. Post-ERCP Pancreatitis: Prevention, Diagnosis and Management. Medicina (Kaunas). 2022;58(9):1261.
  • Cotton PB, Lehman G, Vennes J, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc. 1991;37(3):383-393.
  • Zhang Y, Ye XL, Wan XY. Early prediction of post-endoscopic retrograde cholangiopancreatography pancreatitis via dynamic changes of leukocyte: A retrospective study. J Formos Med Assoc. 2024;17:S0929-6646(24)00431-5.
  • Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-111.
  • Gao W, Yang HX, Ma CE. Correction: The Value of BISAP Score for Predicting Mortality and Severity in Acute Pancreatitis: A Systematic Review and Meta-Analysis. PLoS One. 2015;10(10):e0142025.
  • Kiat TTJ, Gunasekaran SK, Junnarkar SP, Low JK, Woon W, Shelat VG. Are traditional scoring systems for severity stratification of acute pancreatitis sufficient?. Ann Hepatobiliary Pancreat Surg. 2018;22(2):105-115.
  • Bhatt H. Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: An Updated Review of Current Preventive Strategies. Clin Exp Gastroenterol. 2021;14:27-32.
  • Abdel Aziz AM, Lehman GA. Pancreatitis after endoscopic retrograde cholangio-pancreatography. World J Gastroenterol. 2007;13(19):2655-2668.
  • Yuan M, Li W, Zhu Y, Yu B, Wu J. Asprosin: A Novel Player in Metabolic Diseases. Front Endocrinol (Lausanne). 2020;11:64.
  • van Raalte DH, Diamant M. Glucolipotoxicity and beta cells in type 2 diabetes mellitus: target for durable therapy?. Diabetes Res Clin Pract. 2011;93 Suppl 1:S37-S46.
  • Jenei-Lanzl Z, Zwingenberg J, Lowin T, Anders S, Straub RH. Proinflammatory receptor switch from Gαs to Gαi signaling by β-arrestin-mediated PDE4 recruitment in mixed RA synovial cells. Brain Behav Immun. 2015;50:266-274.
  • Jiang J, Dingledine R. Prostaglandin receptor EP2 in the crosshairs of anti-inflammation, anti-cancer, and neuroprotection. Trends Pharmacol Sci. 2013;34(7):413-423.
  • Zimmerman NP, Kumar SN, Turner JR, Dwinell MB. Cyclic AMP dysregulates intestinal epithelial cell restitution through PKA and RhoA. Inflamm Bowel Dis. 2012;18(6):1081-1091.
  • Yang Y, Sun Z, Li J, Song Y, Xu W. Neutrophil-derived IL-10 increases CVB3-induced acute pancreatitis pathology via suppressing CD8+T cell activation while increasing macrophage STAT3-IL-6 cascade. Cytokine. 2024;184:156784.
  • Senyigit A, Durmus S, Gelisgen R, Uzun H. Oxidative Stress and Asprosin Levels in Type 2 Diabetic Patients with Good and Poor Glycemic Control. Biomolecules. 2024;14(9):1123.
  • Ge R, Chen JL, Zheng F, Yin SM, Dai M, Wang YM et al. Asprosin promotes vascular inflammation via TLR4-NFκB-mediated NLRP3 inflammasome activation in hypertension. Heliyon. 2024;10(11):e31659.
  • Shabir K, Gharanei S, Orton S, Patel V, Chauhan P, Karteris E et al. Asprosin Exerts Pro-Inflammatory Effects in THP-1 Macrophages Mediated via the Toll-like Receptor 4 (TLR4) Pathway. Int J Mol Sci. 2022;24(1):227.
  • Wang Y, Qu H, Xiong X, Qiu Y, Liao Y, Chen Y et al. Plasma Asprosin Concentrations Are Increased in Individuals with Glucose Dysregulation and Correlated with Insulin Resistance and First-Phase Insulin Secretion. Mediators Inflamm. 2018;2018:9471583.
  • Ma L, Wang Z, Sun L, Li M, Wu Q, Liu M et al. Association analysis between serum asprosin and metabolic characteristics, Complications in type 2 diabetic patients with different durations. J Diabetes Investig. 2024;15(12):1781-1787.
  • Zhang H, Hu W, Zhang G. Circulating asprosin levels are increased in patients with type 2 diabetes and associated with early-stage diabetic kidney disease. Int Urol Nephrol. 2020;52(8):1517-1522.
  • Jones AG, Hattersley AT. The clinical utility of C-peptide measurement in the care of patients with diabetes. Diabet Med. 2013;30(7):803-817.
  • Shabir K, Gharanei S, Orton S, et al. Asprosin Exerts Pro-Inflammatory Effects in THP-1 Macrophages Mediated via the Toll-like Receptor 4 (TLR4) Pathway. Int J Mol Sci. 2022;24(1):227.
  • Hong T, Li JY, Wang YD, et al. High Serum Asprosin Levels Are Associated with Presence of Metabolic Syndrome. Int J Endocrinol. 2021;2021:6622129.

ERCP Sonrası Pankreatit ve Serum Asprosin Düzeyi: Beta Hücre Hasarı ile İlişkili Potansiyel Bir Belirteç

Year 2025, Volume: 78 Issue: 3, 245 - 257, 30.09.2025
https://doi.org/10.65092/autfm.1747924

Abstract

Amaç: Asprosin, yağ dokusu tarafından üretilen ve glikoz metabolizmasını düzenlemede önemli rolü olan bir proteindir. Pankreatitte inflamasyon beta hücre hasarına ve beta hücre fonksiyonlarının bozulmasına yol açar. Son çalışmalar asprosin ile pankreas beta hücre hasarı arasında bir ilişki olduğunu göstermiştir. Bu araştırma, endoskopik retrograd kolanjiyopankreatografi (ERCP) sonrasında gelişen pankreatit ile beta hücre hasarının bir göstergesi olarak kabul edilen asprosin seviyeleri arasındaki ilişkiyi incelemeyi amaçlamıştır.
Yöntem: Çalışma Ankara Bilkent Şehir Hastanesi'nde ERCP sonrası pankreatit gelişen 25 hasta ve kontrol grubu olarak 21 katılımcı ile yürütüldü. Akut pankreatit tanısı klinik, görüntüleme ve laboratuvar bulgularının korelasyonu ile konuldu. Ayrıca, ERCP sonrası pankreatit grubu hastalık şiddetine göre “hafif” ve “orta-şiddetli” olarak sınıflandırıldı ve asprosin seviyeleri gruplar arasında karşılaştırıldı. Asprosin ile biyokimyasal ve hematolojik parametreler arasındaki korelasyonlar analiz edildi.
Bulgular: Serum asprosin konsantrasyonları ERCP sonrası pankreatit grubunda yüksekti (p < 0,001). Amilaz, lipaz, GGT, AST, toplam ve direkt bilirubin seviyeleri de pankreatit grubunda anlamlı şekilde arttı. Pankreatit grubunda, asprosin seviyeleri ile lökosit (r = -0,433; p = 0,031) ve lenfosit sayıları (r = -0,440; p = 0,028) arasında negatif bir korelasyon gözlendi. Asprosin konsantrasyonları ile pankreatit şiddeti arasında anlamlı bir korelasyon gözlenmedi (p = 0,347).
Sonuç: Post-ERCP pankreatitli hastalarda asprosin düzeyleri artar ve bu potansiyel olarak inflamatuar yanıtla ilişkilendirilebilir. Ancak asprosin düzeylerinin hastalığın şiddetini doğrudan yansıtmadığı düşünülmektedir. Bu nedenle asprosin pankreas beta hücre hasarı ve inflamasyonuyla ilişkili yeni bir biyobelirteç adayı olarak düşünülebilir; ancak tanısal ve prognostik rolünü açıklamak için ek araştırmalara ihtiyaç vardır.

References

  • Zerem E. Treatment of severe acute pancreatitis and its complications. World J Gastroenterol. 2014;20(38):13879-13892.
  • Krishna SG, Kamboj AK, Hart PA, Hinton A, Conwell DL. The Changing Epidemiology of Acute Pancreatitis Hospitalizations: A Decade of Trends and the Impact of Chronic Pancreatitis. Pancreas. 2017;46(4):482-488.
  • Vonderau JS, Desai CS. Type 3c: Understanding pancreatogenic diabetes. JAAPA. 2022;35(11):20-24.
  • Wynne K, Devereaux B, Dornhorst A. Diabetes of the exocrine pancreas. J Gastroenterol Hepatol. 2019;34(2):346-354.
  • Romere C, Duerrschmid C, Bournat J, Constable P, Jain M, Xia F et al. Asprosin, a Fasting-Induced Glucogenic Protein Hormone. Cell. 2016;165(3):566-579.
  • Diao H, Li X, Xu Y, Xing X, Pang S. Asprosin, a novel glucogenic adipokine implicated in type 2 diabetes mellitus. J Diabetes Complications. 2023;37(11):108614.
  • Nam H, Hong SS, Jung KH, Kang S, Park MS, Kang S, et al. A Serum Marker for Early Pancreatic Cancer With a Possible Link to Diabetes. J Natl Cancer Inst. 2022;114(2):228-234.
  • Wang R, Hu W. Asprosin promotes β-cell apoptosis by inhibiting the autophagy of β-cell via AMPK-mTOR pathway. J Cell Physiol. 2021;236(1):215-221.
  • Lee T, Yun S, Jeong JH, Jung TW. Asprosin impairs insulin secretion in response to glucose and viability through TLR4/JNK-mediated inflammation. Mol Cell Endocrinol. 2019;486:96-104.
  • Yuan M, Li W, Zhu Y, Yu B, Wu J. Asprosin: A Novel Player in Metabolic Diseases. Front Endocrinol (Lausanne). 2020;11:64.
  • Cozma MA, Angelescu C, Haidar A, Mateescu RB, Diaconu CC. Incidence, Risk Factors, and Prevention Strategies for Post-ERCP Pancreatitis in Patients with Biliopancreatic Disorders and Acute Cholangitis: A Study from a Romanian Tertiary Hospital. Biomedicines. 2025;13(3):727.
  • Morales SJ, Sampath K, Gardner TB. A Review of Prevention of Post-ERCP Pancreatitis. Gastroenterol Hepatol (N Y). 2018;14(5):286-292.
  • Cahyadi O, Tehami N, de-Madaria E, Siau K. Post-ERCP Pancreatitis: Prevention, Diagnosis and Management. Medicina (Kaunas). 2022;58(9):1261.
  • Cotton PB, Lehman G, Vennes J, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc. 1991;37(3):383-393.
  • Zhang Y, Ye XL, Wan XY. Early prediction of post-endoscopic retrograde cholangiopancreatography pancreatitis via dynamic changes of leukocyte: A retrospective study. J Formos Med Assoc. 2024;17:S0929-6646(24)00431-5.
  • Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-111.
  • Gao W, Yang HX, Ma CE. Correction: The Value of BISAP Score for Predicting Mortality and Severity in Acute Pancreatitis: A Systematic Review and Meta-Analysis. PLoS One. 2015;10(10):e0142025.
  • Kiat TTJ, Gunasekaran SK, Junnarkar SP, Low JK, Woon W, Shelat VG. Are traditional scoring systems for severity stratification of acute pancreatitis sufficient?. Ann Hepatobiliary Pancreat Surg. 2018;22(2):105-115.
  • Bhatt H. Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: An Updated Review of Current Preventive Strategies. Clin Exp Gastroenterol. 2021;14:27-32.
  • Abdel Aziz AM, Lehman GA. Pancreatitis after endoscopic retrograde cholangio-pancreatography. World J Gastroenterol. 2007;13(19):2655-2668.
  • Yuan M, Li W, Zhu Y, Yu B, Wu J. Asprosin: A Novel Player in Metabolic Diseases. Front Endocrinol (Lausanne). 2020;11:64.
  • van Raalte DH, Diamant M. Glucolipotoxicity and beta cells in type 2 diabetes mellitus: target for durable therapy?. Diabetes Res Clin Pract. 2011;93 Suppl 1:S37-S46.
  • Jenei-Lanzl Z, Zwingenberg J, Lowin T, Anders S, Straub RH. Proinflammatory receptor switch from Gαs to Gαi signaling by β-arrestin-mediated PDE4 recruitment in mixed RA synovial cells. Brain Behav Immun. 2015;50:266-274.
  • Jiang J, Dingledine R. Prostaglandin receptor EP2 in the crosshairs of anti-inflammation, anti-cancer, and neuroprotection. Trends Pharmacol Sci. 2013;34(7):413-423.
  • Zimmerman NP, Kumar SN, Turner JR, Dwinell MB. Cyclic AMP dysregulates intestinal epithelial cell restitution through PKA and RhoA. Inflamm Bowel Dis. 2012;18(6):1081-1091.
  • Yang Y, Sun Z, Li J, Song Y, Xu W. Neutrophil-derived IL-10 increases CVB3-induced acute pancreatitis pathology via suppressing CD8+T cell activation while increasing macrophage STAT3-IL-6 cascade. Cytokine. 2024;184:156784.
  • Senyigit A, Durmus S, Gelisgen R, Uzun H. Oxidative Stress and Asprosin Levels in Type 2 Diabetic Patients with Good and Poor Glycemic Control. Biomolecules. 2024;14(9):1123.
  • Ge R, Chen JL, Zheng F, Yin SM, Dai M, Wang YM et al. Asprosin promotes vascular inflammation via TLR4-NFκB-mediated NLRP3 inflammasome activation in hypertension. Heliyon. 2024;10(11):e31659.
  • Shabir K, Gharanei S, Orton S, Patel V, Chauhan P, Karteris E et al. Asprosin Exerts Pro-Inflammatory Effects in THP-1 Macrophages Mediated via the Toll-like Receptor 4 (TLR4) Pathway. Int J Mol Sci. 2022;24(1):227.
  • Wang Y, Qu H, Xiong X, Qiu Y, Liao Y, Chen Y et al. Plasma Asprosin Concentrations Are Increased in Individuals with Glucose Dysregulation and Correlated with Insulin Resistance and First-Phase Insulin Secretion. Mediators Inflamm. 2018;2018:9471583.
  • Ma L, Wang Z, Sun L, Li M, Wu Q, Liu M et al. Association analysis between serum asprosin and metabolic characteristics, Complications in type 2 diabetic patients with different durations. J Diabetes Investig. 2024;15(12):1781-1787.
  • Zhang H, Hu W, Zhang G. Circulating asprosin levels are increased in patients with type 2 diabetes and associated with early-stage diabetic kidney disease. Int Urol Nephrol. 2020;52(8):1517-1522.
  • Jones AG, Hattersley AT. The clinical utility of C-peptide measurement in the care of patients with diabetes. Diabet Med. 2013;30(7):803-817.
  • Shabir K, Gharanei S, Orton S, et al. Asprosin Exerts Pro-Inflammatory Effects in THP-1 Macrophages Mediated via the Toll-like Receptor 4 (TLR4) Pathway. Int J Mol Sci. 2022;24(1):227.
  • Hong T, Li JY, Wang YD, et al. High Serum Asprosin Levels Are Associated with Presence of Metabolic Syndrome. Int J Endocrinol. 2021;2021:6622129.
There are 35 citations in total.

Details

Primary Language English
Subjects Gastroenterology and Hepatology
Journal Section Articles
Authors

Oğuzhan Zengin 0000-0001-6575-4450

Burak Göre 0000-0002-6082-8323

Oğuz Özturk 0000-0003-1558-8882

Özge Doganay 0000-0002-4756-8264

Abdullah Köse 0009-0003-6824-0094

Ali Can Kurtipek 0000-0002-3504-7402

Andaç Uzdoğan 0000-0003-2950-2680

Feyza Yıldırım 0009-0000-9586-3287

Emra Asfuroglu Kalkan 0000-0002-6017-6142

İhsan Ateş 0000-0003-2858-6229

Publication Date September 30, 2025
Submission Date July 22, 2025
Acceptance Date September 29, 2025
Published in Issue Year 2025 Volume: 78 Issue: 3

Cite

APA Zengin, O., Göre, B., Özturk, O., … Doganay, Ö. (2025). Post-ERCP Pancreatitis and Serum Asprosin: A Potential Marker Associated with Beta Cell Damage. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 78(3), 245-257. https://doi.org/10.65092/autfm.1747924
AMA Zengin O, Göre B, Özturk O, et al. Post-ERCP Pancreatitis and Serum Asprosin: A Potential Marker Associated with Beta Cell Damage. Ankara Üniversitesi Tıp Fakültesi Mecmuası. September 2025;78(3):245-257. doi:10.65092/autfm.1747924
Chicago Zengin, Oğuzhan, Burak Göre, Oğuz Özturk, Özge Doganay, Abdullah Köse, Ali Can Kurtipek, Andaç Uzdoğan, Feyza Yıldırım, Emra Asfuroglu Kalkan, and İhsan Ateş. “Post-ERCP Pancreatitis and Serum Asprosin: A Potential Marker Associated With Beta Cell Damage”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 78, no. 3 (September 2025): 245-57. https://doi.org/10.65092/autfm.1747924.
EndNote Zengin O, Göre B, Özturk O, Doganay Ö, Köse A, Kurtipek AC, Uzdoğan A, Yıldırım F, Asfuroglu Kalkan E, Ateş İ (September 1, 2025) Post-ERCP Pancreatitis and Serum Asprosin: A Potential Marker Associated with Beta Cell Damage. Ankara Üniversitesi Tıp Fakültesi Mecmuası 78 3 245–257.
IEEE O. Zengin et al., “Post-ERCP Pancreatitis and Serum Asprosin: A Potential Marker Associated with Beta Cell Damage”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 78, no. 3, pp. 245–257, 2025, doi: 10.65092/autfm.1747924.
ISNAD Zengin, Oğuzhan et al. “Post-ERCP Pancreatitis and Serum Asprosin: A Potential Marker Associated With Beta Cell Damage”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 78/3 (September2025), 245-257. https://doi.org/10.65092/autfm.1747924.
JAMA Zengin O, Göre B, Özturk O, Doganay Ö, Köse A, Kurtipek AC, Uzdoğan A, Yıldırım F, Asfuroglu Kalkan E, Ateş İ. Post-ERCP Pancreatitis and Serum Asprosin: A Potential Marker Associated with Beta Cell Damage. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2025;78:245–257.
MLA Zengin, Oğuzhan et al. “Post-ERCP Pancreatitis and Serum Asprosin: A Potential Marker Associated With Beta Cell Damage”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 78, no. 3, 2025, pp. 245-57, doi:10.65092/autfm.1747924.
Vancouver Zengin O, Göre B, Özturk O, Doganay Ö, Köse A, Kurtipek AC, et al. Post-ERCP Pancreatitis and Serum Asprosin: A Potential Marker Associated with Beta Cell Damage. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2025;78(3):245-57.