scholarly journals Novel biomarker for predicting sepsis mortality: vitamin D receptor

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110347
Author(s):  
Murat Erdoğan ◽  
Hüseyin Avni Fındıklı
Keyword(s):  
Vitamin D ◽  
Disease Severity ◽  
Vitamin D Receptor ◽  
Area Under The Curve ◽  
Apache Ii ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Kaplan Meier ◽  
Poor Outcomes

Objective There are currently no studies on the role of vitamin D receptor (VDR) levels as a cause of or risk factor for sepsis. We aimed to establish the association between VDR levels and 28-day mortality in critically ill patients with sepsis. Methods This prospective cross-sectional observational study included 148 patients diagnosed with sepsis who were treated in the intensive care unit. We measured VDR levels, laboratory characteristics, and health scores and related them to survival. Results The 148 patients included 96 survivors and 52 non-survivors, with VDR levels of 1.92 and 1.36 ng/mL, respectively. Baseline VDR was a significant predictor of 28-day mortality, with an area under the curve of 0.778. A low VDR level was significantly associated with lower overall survival in patients with sepsis according to Kaplan–Meier curve analysis. VDR levels were also negatively correlated with lactate, C-reactive protein, acute physiological and clinical health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores, and disease severity. Conclusions VDR levels were associated with high 28-day mortality and negatively correlated with lactate, C-reactive protein, APACHE II and SOFA scores, and disease severity in patients with sepsis. VDR levels can predict poor outcomes in patients with sepsis.

scholarly journals Kadar High Sensitivity C-Reactive Protein Berkaitan dengan Lingkar Pinggang pada Lansia

2021 ◽  
Vol 8 (1) ◽  
pp. 21
Author(s):  
Deny Yudi Fitranti ◽  
Bunga Syifarahmi ◽  
Martha Ardiaria ◽  
Nurmasari Widyastuti
Keyword(s):  
Physical Activity ◽  
Vitamin D ◽  
International Physical Activity Questionnaire ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Consecutive Sampling ◽  
Hs Crp ◽  
Activity Questionnaire

<p>Proses penuaan mempengaruhi peningkatan distribusi lemak abdominal dengan indikator lingkar pinggang (LP) dan rasio lingkar pinggang panggul (RLPP). Penimbunan lemak abdominal menyebabkan disfungsi jaringan adiposa sehingga mempengaruhi biomarker proinflamasi yaitu kadar serum <em>high-sensitivity C-reactive Protein</em> (hs-CRP). Penelitian bertujuan untuk mengetahui hubungan LP dan RLPP dengan kadar hs-CRP lansia wanita. Rancangan penelitian <em>cross sectional</em> pada 53 subjek dipilih secara <em>consecutive sampling</em>. Antropometri yang diukur adalah LP dan RLPP. Pengukuran kadar serum hs-CRP dianalisis dengan metode <em>enyme-linked immunosorbent assay</em> (ELISA). Wawancara yang dilakukan yaitu data diri, asupan, aktivitas fisik, dan riwayat konsumsi obat. Data asupan diperoleh dengan metode <em>food recall</em> 3x24 jam. Aktivitas fisik diperoleh menggunakan <em>International Physical Activity Questionnaire</em> (IPAQ). Analisis data digunakan uji korelasi <em>Spearman</em>. Hasil penelitian menunjukkan bahwa persentase LP pada lansia wanita yang berisiko sebesar 90,6%, RLPP yang berisiko sebesar 98,1%, dan kadar hs-CRP tinggi sebesar 30,2%. Terdapat hubungan positif antara LP dengan kadar serum hs-CRP (r=0,417 ; p=0,002). Dalam penelitian ini RLPP, aktivitas fisik, asupan energi, karbohidrat, protein, lemak, serat, vitamin A, vitamin C, vitamin D,vitamin E, dan selenium tidak berkorelasi dengan kadar hs-CRP. Simpulan penelitian ini adalah LP berkorelasi positif dengan kadar serum hs-CRP, namun RLPP tidak berkorelasi dengan kadar serum hs-CRP</p>

scholarly journals C-Reactive Protein and Lymphocyte are important indicators of severe coronavirus disease and poor prognosis in elderly patients

2020 ◽  
Author(s):  
Qinglin He ◽  
Xiafen Hu ◽  
Xiaochen Xiang ◽  
Siyang Chen ◽  
Wanxin Liu ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Disease Severity ◽  
Area Under The Curve ◽  
Reference Interval ◽  
The Elderly ◽  
C Reactive Protein ◽  
Roc Curve Analysis ◽  
Dynamic Changes ◽  
Reactive Protein ◽  
Risk Of Death

Abstract Objective：To explore the value of C-reactive protein (CRP) and lymphocyte (L) in the assessment of disease severity and prognosis of elderly COVID-19 patients.Methods: A total of 194 positive COVID-19 patients were collected from Tianyou Hospital and Puren Hospital, affiliated hospital of Wuhan University of Science and Technology. Their demographic characteristics were analyzed. The dynamic changes of CRP and L in peripheral blood were retrospectively studied.Results: (1) There were significant statistical differences in CRP, L in clinical typing and clinical outcome in patients over 60 years old compared with those under 60 years old. Survival analysis showed that the risk of death was greater in patients over 60 than in those under 60.（2）In 125 patients over 60 years old, the hospitalized patients with severe or critical types of disease had significantly higher CRP than those with moderate type (p<0.01). In the outcome of the elderly patients, the CRP of the patients with the outcomes of discharge, improvement, aggravation and death increased successively (p<0.01). According to the analysis of Logistic regression model, the increase of CRP constitutes a risk factor for death in elderly patients. (3) In the ROC curve analysis to distinguish the death outcome and non-death outcome of COVID-19 patients, the area under the curve (AUC) of CRP and L was 0.751 and 0.720 respectively. CRP and L had good diagnostic accuracy for the death outcome of patients. (4) Changes in CRP were correlated with changes in CT imaging and were consistent with changes in the course of the disease.Conclusions: (1) The data collected in this research showed that the cumulative survival rate of patients over 60 years old was lower than that of patients under 60 years old. With the increase of age, the CRP of patients showed an increasing trend, and the L of patients showed a characteristic lower than the normal reference interval. (2) CRP and L are important monitoring indicators of COVID-19 in elderly patients. Combined with CT examination and observation of their dynamic changes, CRP and L are of important clinical guiding value for the judgment of disease severity and the evaluation of prognosis.

scholarly journals Δείκτες φλεγμονής και λοίμωξης στους αρρώστους της εντατικής θεραπείας

2013 ◽  
Author(s):  
Λαμπρινή Τίνα
Keyword(s):  
Protein C ◽  
Tumor Necrosis ◽  
Antithrombin Iii ◽  
Area Under The Curve ◽  
Interleukin 10 ◽  
Apache Ii ◽  
C Reactive Protein ◽  
C Protein ◽  
Reactive Protein ◽  
Necrosis Factor

Σκοπός: Σειρά μελετών έχουν ασχοληθεί με το φαινόμενο της σήψης. Δεν έχει γίνει όμως προσπάθεια μέχρι τώρα να μελετηθούν βαρέως πάσχοντες ασθενείς κατά την πορεία τους στα διάφορα στάδια της σήψης για να διαπιστωθεί αν υπάρχουν κλινικά ή εργαστηριακά ευρήματα που να μπορούν να προβλέψουν την επιδείνωση ή βελτίωση των ασθενών αυτών. Έτσι σκοπός της μελέτης μας αποτέλεσε η εύρεση εκείνων των κλινικών αλλά κυρίως εργαστηριακών παραμέτρεων που θα μπορούσαν να προσφέρουν την δυνατότητα πρόβλεψης της μεταβολής σταδίου των σηπτικών αρρώστων της ΜΕΘ. Μέθοδος: Σην μελέτη μας συμπεριλήφθησαν 56 ασθενείς ΜΕΘ: με SIRS, σε διάφορα στάδια σήψης (σήψη, βαρειά σήψη και σηπτική καταπληξία) και σε καταστάσεις που δυνητικά μπορούν να εξελιχθούν σε SIRS και σήψη (πολυτραυματίες και χειρουργημένοι ασθενείς). Μετρήθηκαν στο ορό του αίματος Θρομβοποιητίνη thrombopoitin TPO, Προκαλσιτονίνη procalcitonin - PCT, C αντιδρώσα πρωτεΐνη C reactive protein - CRP, Ιντερλευκίνη 6 Interleukin 6 -IL-6, Παράγοντας νέκρωσης των όγκων Α Tumor Necrosis Factor a-TNFα, Ιντερλευκίνη 1β Interleukin 1b - IL-1b Ιντερλευκίνη 10 Interleukin 10 - IL-10 Αντιθρομβίνη ΙΙΙ antithrombin III - ATIII, Πρωτεΐνη C protein C - PrC, Δ Διμερή D – dimmers – dds, Ινωδογόνο fibrinogen – Fibrin, Πλασμινογόνο Plasminogen, Παράγοντες πήξης FV, FVII, FVIII, FIX, FvWillebrand, FX. Επίσης μετρήθηκαν αέρια αίματος, οι συνήθεις εργαστηριακοί παράμετροι (λευκά (WBC) και ερυθρά αιμοσφαίρια (RBC), αιματοκρίτης (HT), αιμοπετάλια (PTL), κρεατινίνη (CRE), χολερυθρίνη (BIL), χρόνος προθρομβίνης (PT) και μερικής θρπομβοπλαστίνης (PTT,) γαλακτικό οξύ (lactate), σάκχαρο αίματος (glu), αλβουμίνη πλάσματος (alb). Η πρώτη μέτρηση έγινε κατά την εισαγωγή στην ΜΕΘ. Στην συνέχεια πραγματοποιήθηκαν επαναλαμβανόμενες μετρήσεις (από 48 ώρες και κάθε 2 ημέρες για 10 ημέρες συνολικά (μέχρι 6 μετρήσεις)). Παράλληλα συνεχίσθηκε η κλινική αξιολόγηση του σταδίου της σήψης και των υπόλοιπων κλινικών στοιχείων των ασθενών. Σε περίπτωση παρατεταμένης νοσηλείας, επανελήφθησαν οι μετρήσεις των εξεταζόμενων παραγόντων κάθε φορά που ο ασθενής άλλαζε στάδιο σήψης είτε βελτιούμενος είτε επιδεινούμενος. Αποτελέσματα: Κατά την εισαγωγή, οι ασθενείς στα διάφορα στάδια της σήψης, αυτοί με Sirs κοι οι πολυτραυματίες ή χειρουργημένοι ασθενείς είχαν διαφορετικά APACHE II και SOFA scores (p<0.05 και για τα δυο). Τα επίπεδα TNFα ήταν σημαντικά υψηλότερα σε ασθενείς με τραύμα/χειρουργημένους που στην πορεία νοσηλείας τους επιδεινώθηκαν σε SIRS ή στα διάφορα στάδια της σήψης (p=0.002). Οι ασθενείς με SIRS που επιδεινώθηκαν στα διάφορα στάδια της σήψης εμφάνισαν θρομβοπενία σε αντίθεση με αυτούς που βελτιώθηκαν (p=002). Οι ασθενείς με σήψη που επιδεινώθηκαν σε σοβρή σήψη και σηπτικό shock είχαν αυξημένα επίπεδα IL-1b και IL-10 και υψηλότερα APACHE II, SOFA and Lung Injury scores σε σχέση με αυτούς που βελτιώθηκαν (p<0.05-0.001). Οι ασθενείς με σηπτικό shock που απεβίωσαν είχαν χαμηλότερη δραστηριότητα FVII, FIX και PrC και υψηλότερα επίπεδα γαλακτικού οξέως και LIS score (p<0.05-0.01). Η καμπύλη ROC που σχεδιάσθηκε για την προγνωστική ικανότητα του TNFα να διακρίνει ποιοι ασθενείς με τραύμα/χειρουρική επέμβαση θα επιδεινωθούν σε sirs ή στα στάδια της σήψης είχε περιοχή κάτω από την καμπύλη (area under the curve AUC) 0.86, τιμή cutoff 1.39 pg/ml με ευαισθησία 75% και ειδικότητα 90%. Η AUC για την τιμή των αιμοπεταλίων που μπορεί να προβλέψει ποιοι ασθενείς με sirs θα επιδεινωθούν στα διάφορα στάδια της σήψης ήταν 0.84 με τιμή cutoff 1.56 x 105/mm3 με ευαισθησία 70% και ειδικότητα 80%. AUCs για IL-1b, TNFa, SOFA και LIS scores για την πρόγνωση ασθενών με σήψη που θα επιδεινωθούν ήταν 0.85, 0.80, 0.82 και 0.82, αντίστοιχα. AUCs για FIX, lactate και λόγου PaO2/FiO2 για τους ασθενείς με σηπτικό shock που θα απεβιώσουν ήταν 0.83, 0.87 και 0.779 αντίστοιχα. Συμπεράσματα: Οι διαταραχές πηκτικότητας και οι φλεγμονώδεις κυττοκίνες μπορούν να προβλέψουν ποιοι ασθενείς που εισάγονται στην ΜΕΘ θα επιδεινωθούν ή θα βελτιωθούν κατά την διάρκεια της νοσηλείας τους, ενώ άλλοι δείκτες όπως η προκαλσιτονίνη ή ή θρομβοποιητίνη και η C αντιδρώσα πρωτεϊνη δεν έχουν προγνωστική αξία.Συμπεράσματα: Οι διαταραχές πηκτικότητας και οι φλεγμονώδεις κυττοκίνες μπορούν να προβλέψουν ποιοι ασθενείς που εισάγονται στην ΜΕΘ θα επειδινωθούν ή θα βελτιωθούν κατά την διάρκεια της νοσηλείας τους, ενώ άλλοι δείκτες όπως η προκαλσιτονίνη ή ή θρομβοποιητίνη και η C αντιδρώσα πρωτεϊνη δεν έχουν προγνωστική αξία.

Association between vitamin D level and prognostic factors among patients infected with SARS-CoV-2

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mehrdad Haghighi ◽  
Seyed Shayan Ebadi ◽  
Hussein Soleimantabar ◽  
Atefe Shadkam ◽  
Seyed Alireza Ebadi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Prognostic Factors ◽  
Medical Records ◽  
Lymphocyte Count ◽  
Cross Sectional Study ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
The Mean ◽  
D Dimer

Abstract Objectives The present study aimed to evaluate the presence of any relationship between vitamin D and prognostic factors among patients infected with SARS-CoV-2. Methods This retrospective cross-sectional study was conducted among patients admitted from March to August 2020 in a referral hospital, Tehran, Iran. All patients aged 18–65 who had not any comorbidity participated in the study. The diagnosis of COVID-19 was established using the rRT-PCR test for SARS-CoV-2 detection. Then the incidence of lung involvement and biochemical markers including vitamin D level, c-reactive protein, D-dimer, lymphocyte count, platelet count, white blood cell count, and lactic acid dehydrogenase, were extracted through medical records. Results Altogether, 84 patients met our study criteria, and the information of 68 (80.9%) participants were collected. Among all 68 patients, 45 (66.2%) were male. The mean (SD) age of all participants was 52.4 (10.4) years old. Among 24 (35.2%) clients who died due to SARS-CoV-2, 20 (83.3%) patients were male (p=0.02). The mean (SD) of vitamin D level was 24.1 (13.6) ng/dL. No association between vitamin D level and prognostic factors, including CRP, lymphocyte count, D-dimer, LDH, and HRCT scan score, was observed. Also, the vitamin D level of the dead patients was not significantly different from that of the treated patients. Conclusions Our findings indicated no significant relationship between vitamin D level and prognostic factors or outcomes of patients infected with SARS-CoV-2.

scholarly journals Vitamin D epimers are associated with circulating haemoglobin levels independently of C-reactive protein

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
La-or Chailurkit ◽  
Piyamitr Sritara ◽  
Prin Vathesatogkit ◽  
Sukit Yamwong ◽  
Nisakron Thongmung ◽  
...  
Keyword(s):  
Vitamin D ◽  
Venous Blood ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Total Serum ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Long Term Follow Up

AbstractVitamin D deficiency has been shown to be associated with anaemia. Circulating 25(OH)D consists of both epimeric and nonepimeric forms. However, the relative roles of epimeric and nonepimeric vitamin D in regulating anaemia and haemoglobin levels remain unknown. Therefore, in this study, we examined the effect of vitamin D, including its epimers, on haemoglobin levels, independently of its effect on circulating high-sensitivity C-reactive protein (hsCRP). This was a cross-sectional study of 1655 subjects from a long-term follow-up cohort at the Electricity Generating Authority of Thailand. Venous blood sample were collected for determination of vitamin D [25(OH)D2, 25(OH)D3, 3′-epi-25(OH)D2, and 3′-epi-25(OH)D3], haemoglobin, and hsCRP levels. Data are presented as mean ± standard deviation. Age, sex, and body mass index (BMI) were significantly associated with circulating haemoglobin levels, while no association was found between total serum 25(OH)D and haemoglobin levels. However, when total 25(OH)D was separated into 3′-epimeric and non-3′-epimeric forms, 3′-epi-25(OH)D was significantly associated with haemoglobin levels, independently of age, sex, and BMI (P < 0.01). No association was found between non-3′-epi-25(OH)D and haemoglobin. When hsCRP was added to the model, the effect 3′-epi-25(OH)D on haemoglobin levels remained significant (P < 0.01). In conclusion, vitamin D epimers are associated with circulating haemoglobin levels, which supports the role of vitamin D in red blood cell and iron physiology.

scholarly journals C-Reactive Protein and Lymphocyte are important indicators of severe coronavirus disease and poor prognosis in elderly patients

2020 ◽  
Author(s):  
Qinglin He ◽  
Xiafen Hu ◽  
Xiaochen Xiang ◽  
Siyang Chen ◽  
Wanxin Liu ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Disease Severity ◽  
Area Under The Curve ◽  
Reference Interval ◽  
The Elderly ◽  
C Reactive Protein ◽  
Roc Curve Analysis ◽  
Dynamic Changes ◽  
Reactive Protein ◽  
Risk Of Death

Abstract Objective：To explore the value of C-reactive protein (CRP) and lymphocyte (L) in the assessment of disease severity and prognosis of elderly COVID-19 patients.Methods: A total of 194 positive COVID-19 patients were collected from Tianyou Hospital and Puren Hospital, affiliated hospital of Wuhan University of Science and Technology. Their demographic characteristics were analyzed. The dynamic changes of CRP and L in peripheral blood were retrospectively studied.Results: (1) There were significant statistical differences in CRP, L in clinical typing and clinical outcome in patients over 60 years old compared with those under 60 years old. Survival analysis showed that the risk of death was greater in patients over 60 than in those under 60.（2）In 125 patients over 60 years old, the hospitalized patients with severe or critical types of disease had significantly higher CRP than those with moderate type (p<0.01). In the outcome of the elderly patients, the CRP of the patients with the outcomes of discharge, improvement, aggravation and death increased successively (p<0.01). According to the analysis of Logistic regression model, the increase of CRP constitutes a risk factor for death in elderly patients. (3) In the ROC curve analysis to distinguish the death outcome and non-death outcome of COVID-19 patients, the area under the curve (AUC) of CRP and L was 0.751 and 0.720 respectively. CRP and L had good diagnostic accuracy for the death outcome of patients. (4) Changes in CRP were correlated with changes in CT imaging and were consistent with changes in the course of the disease.Conclusions: (1) The cumulative survival rate of patients over 60 years old was lower than that of patients under 60 years old. With the increase of age, the CRP of patients showed an increasing trend, and the L of patients showed a characteristic lower than the normal reference interval. (2) CRP and L are important monitoring indicators of COVID-19 in elderly patients. Combined with CT examination and observation of their dynamic changes, CRP and L are of important clinical guiding value for the judgment of disease severity and the evaluation of prognosis.

scholarly journals Molecular Epidemiology and Clinical Features Analysis of Respiratory Adenovirus Infections Reveals Correlations between Genotype, Inflammatory Biomarkers, and Disease Severity

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Hui Dai ◽  
Hongli Xi ◽  
Li Huang ◽  
Zhaohu Yuan ◽  
Yike Liao ◽  
...  
Keyword(s):  
Disease Severity ◽  
Clinical Laboratory ◽  
Respiratory Infections ◽  
Cross Sectional Study ◽  
Inflammatory Biomarkers ◽  
Hospitalized Children ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Clinical Profiles

Background. Human adenoviruses (HAdVs) are commonly causing respiratory disease. We molecularly genotyped HAdV circulating in Chinese hospitalized children with respiratory infections and summarized the clinical profiles and common inflammatory biomarkers, so as to better determine their associations with disease severity. Method. Children with respiratory single HAdV infection cases that occurred from December 2017 to March 2019 were enrolled for a cross-sectional study. Clinical/laboratory features based on the genotypes of respiratory HAdV infection were reviewed for comparative analysis. Results. A total of 84 patients were enrolled, and HAdV types were identified from 82 patients. Species B (HAdV-7, 44%; HAdV-3, 43%, and HAdV-14, 5%) was the most common, followed by C (HAdV-2, 4% and HAdV-1, 1%) and E (HAdV-4, 1%). Severe HAdV infection and HAdV-7 infection groups were associated with significantly longer duration of fever and hospitalized days, higher morbidity of tachypnea/dyspnea, more pleural effusion, more respiratory rales, more frequently required mechanical ventilation, and significantly higher fatality rate. The elevated procalcitonin (PCT) and C-reactive protein (CRP) levels were significantly associated with severe HAdV infection. Conclusions. HAdV-7 and HAdV-3 were the most common types among children with respiratory adenovirus infection; vaccines against these two genotypes are in urgent need. PCT and CRP are significantly associated with the severity of HAdV infection.

scholarly journals Associations of 25 Hydroxyvitamin D and High Sensitivity C-reactive Protein Levels in Early Life

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 15
Author(s):  
Nicklas Brustad ◽  
Nadia R. Fink ◽  
Jakob Stokholm ◽  
Klaus Bønnelykke ◽  
Nilofar V. Følsgaard ◽  
...  
Keyword(s):  
Vitamin D ◽  
Early Life ◽  
High Sensitivity ◽  
Low Grade ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
Reactive Protein ◽  
25 Hydroxyvitamin D ◽  
Hs Crp

Vitamin D deficiency and elevated high sensitivity C-reactive protein (hs-CRP) have been associated with several health outcomes, but knowledge on early life trajectories and association between 25 hydroxyvitamin D (25(OH)D) and hs-CRP is lacking. We investigated the association between longitudinal measurements of 25(OH)D and hs-CRP, respectively, from pregnancy to childhood and throughout childhood in two Danish mother–child cohorts—the COPSAC2010 and COPSAC2000. In COPSAC2010, there was an association between 25(OH)D concentrations at week 24 in pregnancy and at age 6 months in childhood (n = 633): estimate (95% CI); 0.114 (0.041;0.187), p = 0.002, and between 25(OH)D at age 6 months and 6 years (n = 475): 0.155 (0.083;0.228), p < 0.001. This was also demonstrated in the COPSAC2000 cohort between 25(OH)D concentrations in cord blood and at age 4 years (n = 188): 0.294 (0.127;0.461), p < 0.001 and at age 6 months and 4 years (n = 264): 0.260 (0.133;0.388), p < 0.001. In COPSAC2000, we also found an association between hs-CRP at age 6 months and 12 years in childhood (n = 232): 0.183 (0.076;0.289), p < 0.001. Finally, we found a negative association between the cross-sectional measurements of 25(OH)D and hs-CRP at age 6 months (n = 613) in COPSAC2010: −0.004 (−0.008;−0.0004), p = 0.030, but this was not replicated in COPSAC2000. In this study, we found evidence of associations across timepoints of 25(OH)D concentrations from mid-pregnancy to infancy and through childhood and associations between hs-CRP levels during childhood, although with weak correlations. We also found a negative cross-sectional association between 25(OH)D and hs-CRP concentrations in COPSAC2010 proposing a role of vitamin D in systemic low-grade inflammation, though this association was not present in COPSAC2000.

scholarly journals Early Changes in Blood Urea Nitrogen (BUN) Can Predict Mortality in Acute Pancreatitis: Comparative Study between BISAP Score, APACHE-II, and Other Laboratory Markers—A Prospective Observational Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Elizabeth Pando ◽  
Piero Alberti ◽  
Rodrigo Mata ◽  
María José Gomez ◽  
Laura Vidal ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Prospective Observational Study ◽  
Predictive Accuracy ◽  
Multiorgan Failure ◽  
Area Under The Curve ◽  
Apache Ii ◽  
Operating Characteristics ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Score Apache

Background. Changes in BUN have been proposed as a risk factor for complications in acute pancreatitis (AP). Our study aimed to compare changes in BUN versus the Bedside Index for Severity in Acute Pancreatitis (BISAP) score and the Acute Physiology and Chronic Health Evaluation-II score (APACHE-II), as well as other laboratory tests such as haematocrit and its variations over 24 h and C-reactive protein, in order to determine the most accurate test for predicting mortality and severity outcomes in AP. Methods. Clinical data of 410 AP patients, prospectively enrolled for study at our institution, were analyzed. We define AP according to Atlanta classification (AC) 2012. The laboratory test’s predictive accuracy was measured using area-under-the-curve receiver-operating characteristics (AUC) analysis and sensitivity and specificity tests. Results. Rise in BUN was the only score related to mortality on the multivariate analysis ( p = 0.000 , OR: 12.7; CI 95%: 4.2−16.6). On the comparative analysis of AUC, the rise in BUN was an accurate test in predicting mortality (AUC: 0.842) and persisting multiorgan failure (AUC: 0.828), similar to the BISAP score (AUC: 0.836 and 0.850) and APACHE-II (AUC: 0.756 and 0.741). The BISAP score outperformed both APACHE-II and rise in BUN at 24 hours in predicting severe AP (AUC: 0.873 vs. 0.761 and 0.756, respectively). Conclusion. Rise in BUN at 24 hours is a quick and reliable test in predicting mortality and persisting multiorgan failure in AP patients.

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