T1737 Usefulness of 13C-Labeled Mixed Triglyceride Breath Test for Evaluating Exocrine Pancreatic Function After Pancreatic Surgery

Abstract Two noninvasive tests for assessing pancreatic exocrine function, the cholesteryl-[14C]octanoate breath test and the HPLCN-benzoyl-tyrosyl-p-aminobenzoic acid/p-aminosalicylic acid (NBT-PABA/PAS) test, were simultaneously performed in nine patients with pancreatic exocrine insufficiency due to chronic pancreatitis and in nine healthy volunteers. 14CO2 output in breath and plasma PABA concentration rose slowly in patients but increased rapidly in healthy subjects. The measurement time giving the best discrimination between both groups was 120 min for the cholesteryl-[14C]octanoate breath test and 90 min for the plasma PABA test. At these points, both single-sample tests had essentially identical diagnostic sensitivity. The diagnostic sensitivities of the two single-sample tests were equal to that of the cumulative 6-h urinary PABA recovery and the cumulative 6-h urinary PABA/PAS ratio. We conclude that, for both the cholesteryl-[14C]octanoate breath test and the plasma PABA test, a single test sample is sufficient for rapid detection of impaired exocrine pancreatic function.

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13C labelled cholesteryl octanoate breath test for assessing pancreatic exocrine insufficiency

Gut ◽

10.1136/gut.42.1.81 ◽

1998 ◽

Vol 42 (1) ◽

pp. 81-87 ◽

Cited By ~ 34

Author(s):

M Ventrucci ◽

A Cipolla ◽

G M Ubalducci ◽

A Roda ◽

E Roda

Keyword(s):

Breath Test ◽

Pancreatic Insufficiency ◽

Pancreatic Enzyme ◽

Pancreatic Disease ◽

Exocrine Pancreatic Function ◽

Significant Rise ◽

Exocrine Pancreatic Insufficiency ◽

Pancreatic Function ◽

Healthy Controls ◽

Exocrine Insufficiency

Background—A non-invasive test for assessment of fat digestion has been developed based on the intraluminal hydrolysis of cholesteryl-[1-13C]octanoate by pancreatic esterase.Aims—To determine the diagnostic performance of this breath test in the assessment of exocrine pancreatic function.Methods—The test was performed in 20 healthy controls, 22 patients with chronic pancreatic disease (CPD), four with biliopancreatic diversion (BPD), and 32 with non-pancreatic digestive diseases (NPD); results were compared with those of other tubeless tests (faecal chymotrypsin and fluorescein dilaurate test).Results—Hourly recoveries of13CO2 were significantly lower in CPD when compared with healthy controls or NPD. In patients with CPD with mild to moderate insufficiency, the curve of 13CO2recovery was similar to that of healthy controls, while in those with severe insufficiency it was flat. In three patients with CPD with severe steatorrhoea, a repeat test after pancreatic enzyme supplementation showed a significant rise in13CO2 recovery. The four BPD patients had low and delayed 13CO2 recovery. Only eight of the 32 patients with NPD had abnormal breath test results. There was a significant correlation between the results of the breath test and those of faecal chymotrypsin, the fluorescein dilaurate test, and faecal fat measurements. For the diagnosis of pancreatic disease using the three hour cumulative 13CO2 recovery test, the sensitivity was 68.2% and specificity 75.0%; values were similar to those of the other two tubeless pancreatic function tests. In seven healthy controls, nine patients with CPD, and nine with NPD a second breath test was performed using Na-[1-13C]octanoate and a pancreatic function index was calculated as the ratio of13C recovery obtained in the two tests: at three hours this index was abnormal in eight patients with CPD and in three with NPD.Conclusion—The cholesteryl-[1-13C]octanoate breath test can be useful for the diagnosis of fat malabsorption and exocrine pancreatic insufficiency.

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Combined Single Day 14C-Triolein Breath Test and Paba Test in the Diagnosis of Malabsorption

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/000456329002700110 ◽

1990 ◽

Vol 27 (1) ◽

pp. 50-55 ◽

Cited By ~ 2

Author(s):

S C Fleming ◽

M S Kapembwa ◽

G E Griffin

Keyword(s):

Breath Test ◽

Gastrointestinal Disease ◽

Pancreatic Insufficiency ◽

Pancreatic Disease ◽

Exocrine Pancreatic Function ◽

Exocrine Pancreatic Insufficiency ◽

Pancreatic Function ◽

Fat Absorption ◽

Aminosalicylic Acid ◽

Function Combination

The 14C-triolein breath test, a recognised index of fat absorption, and the p-aminobenzoic acid (PABA) test, a ‘tubeless’ test of exocrine pancreatic function, have both been widely used in the diagnosis of malabsorption and exocrine pancreatic insufficiency. This study evaluates the potential of a combination of both tests in the investigation of fat absorption and exocrine pancreatic function. Combination of the tests has become technically feasible because of the introduction of high pressure liquid chromatography as the preferred method of analysis for PABA, and use of p-aminosalicylic acid (PAS) as the marker for PABA absorption and metabolism We studied 25 healthy subjects, 11 patients with exocrine pancreatic disease and 12 patients with gastrointestinal disease. The combined test identified subjects with reduced fat absorption and distinguished subjects with exocrine pancreatic insufficiency from those with an intestinal cause of fat malabsorption. The test could be completed in 7 h and had high patient acceptibility. These findings suggest that the combined 14C-triolein breath test and PABA test can be used as a non-invasive, 1-day investigation of fat absorption and exocrine pancreatic function.

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