TY - JOUR T1 - Identification and validation of a multivariable prediction model based on blood plasma and serum metabolomics for the distinction of chronic pancreatitis subjects from non-pancreas disease control subjects JF - Gut JO - Gut SP - 2150 LP - 2158 DO - 10.1136/gutjnl-2020-320723 VL - 70 IS - 11 AU - M Gordian Adam AU - Georg Beyer AU - Nicole Christiansen AU - Beate Kamlage AU - Christian Pilarsky AU - Marius Distler AU - Tim Fahlbusch AU - Ansgar Chromik AU - Fritz Klein AU - Marcus Bahra AU - Waldemar Uhl AU - Robert Grützmann AU - Ujjwal M Mahajan AU - Frank U Weiss AU - Julia Mayerle AU - Markus M Lerch Y1 - 2021/11/01 UR - http://gut.bmj.com/content/70/11/2150.abstract N2 - Objective Chronic pancreatitis (CP) is a fibroinflammatory syndrome leading to organ dysfunction, chronic pain, an increased risk for pancreatic cancer and considerable morbidity. Due to a lack of specific biomarkers, diagnosis is based on symptoms and specific but insensitive imaging features, preventing an early diagnosis and appropriate management.Design We conducted a type 3 study for multivariable prediction for individual prognosis according to the TRIPOD guidelines. A signature to distinguish CP from controls (n=160) was identified using gas chromatography-mass spectrometry and liquid chromatography‐tandem mass spectrometry on ethylenediaminetetraacetic acid (EDTA)-plasma and validated in independent cohorts.Results A Naive Bayes algorithm identified eight metabolites of six ontology classes. After algorithm training and computation of optimal cut-offs, classification according to the metabolic signature detected CP with an area under the curve (AUC) of 0.85 ((95% CI 0.79 to 0.91). External validation in two independent cohorts (total n=502) resulted in similar accuracy for detection of CP compared with non-pancreatic controls in EDTA-plasma (AUC 0.85 (95% CI 0.81 to 0.89)) and serum (AUC 0.87 (95% CI 0.81 to 0.95)).Conclusions This is the first study that identifies and independently validates a metabolomic signature in plasma and serum for the diagnosis of CP in large, prospective cohorts. The results could provide the basis for the development of the first routine laboratory test for CP.Data may be obtained from a third party and are not publicly available. Data are deidentified patient data, which are available from the corresponding author after appropriate application for reuse under research purpose only. ER -