Determination of a glucose-containing tetrasaccharide in urine of patients with acute pancreatitis.

The oligosaccharide Glc alpha 1-6Glc alpha 1-4Glc alpha 1-4Glc (Glc4), formed by amylolytic degradation of starch and glycogen, is excreted at extremely high levels in the urine of patients with acute pancreatitis. To determine if Glc4 is a useful indicator for this disease, we studied 55 patients admitted to the hospital because of acute abdominal pain (possibly acute pancreatitis). The highest values of Glc4 excretion in urine was found in a group of 11 patients with acute pancreatitis. The Glc4 values, but not serum and urine amylase values obtained at admission, correlated significantly with the severity of the disease. In two patients, followed through convalescence, the Glc4 excretion remained elevated for 7 and 2 wk in contrast to serum and urine amylase that returned to normal levels within a few days. It seems probable that glycogen, released from the liver and subsequently degraded by amylase originating from the pancreas, can be measured as Glc4 in the urine. This might be valuable for diagnosing acute pancreatitis and gives indications of the prognosis.