ASSOCIATIONS OF CYTOKINE PROFILE AND EXOCRINE PANCREATIC FUNCTION WITH A SYMPTOM-BASED DEHYDRATION CATEGORY AND SEASON OF PRESENTATION IN CHRONIC PANCREATITIS: A RETROSPECTIVE STUDY.

Abstract

Aim: To evaluate the associations of C-reactive protein (CRP), fecal elastase-1 (FE-1), interleukin-2 receptor (IL-2R), interleukin-6 (IL-6), and transforming growth factor-beta 1 (TGF-β1) with the symptom-based dehydration category and season of presentation in chronic pancreatitis; clinical-group comparisons were secondary.

Materials and methods: Of 132 consecutive inpatient records screened in 2023-2025, 80 with complete results for the five laboratory outcomes were analyzed and 52 incomplete records were excluded; each patient contributed one observation. Unadjusted Kruskal-Wallis, Mann-Whitney U, and Spearman analyses used Holm correction. Five linear models with HC3 robust standard errors simultaneously adjusted for dehydration category, summer presentation, clinical group, age, sex, and disease duration.

Results: Unadjusted analyses associated higher dehydration category with higher CRP and IL-6 and lower FE-1. After mutual adjustment, only IL-6 remained associated with each one-category increase in dehydration (+36.94 pg/mL; 95% CI, 17.98-55.90; Holm-adjusted p=0.0011). Summer presentation was independently associated with higher CRP (+8.46 mg/L) and IL-6 (+44.23 pg/mL), lower FE-1 (-22.89 µg/g), and lower TGF-β1 (-61.12 pg/mL) (all Holm-adjusted p<0.05), but not IL-2R. The five outcomes did not differ across clinical groups.

Conclusion: After adjustment, dehydration category remained independently associated only with IL-6, whereas summer presentation retained associations with CRP, IL-6, FE-1, and TGF-β1. The retrospective observational design precludes causal attribution to heat or dehydration.