scholarly journals Serum soluble PD-1 plays a role in predicting infection complications in patients with acute pancreatitis

2020 ◽  
Author(s):  
Xingxing Yu ◽  
Yu Pan ◽  
Qinglin Fei ◽  
Xianchao Lin ◽  
Zhijiang Chen ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Cell Death ◽  
Risk Factor ◽  
Programmed Cell Death ◽  
Healthy Volunteers ◽  
Independent Risk Factor ◽  
Apache Ii Score ◽  
Enzyme Linked Immunosorbent Assay ◽  
Dependent Manner ◽  
Operating Characteristics

Abstract Background: Most of acute pancreatitis (AP) are mild and self-limiting, however, 15%-20% of patients develop severe AP (SAP) or moderately SAP (MSAP) with local or systemic complications. Infection complications (ICs) result in 40-70% morbidity and high mortality rates among SAP and MSAP patients. It’s require that early identification of SAP and MSAP patients at risk of developing ICs. Several studies have indicated that serum soluble programmed cell death protein (sPD-1) or programmed cell death 1 ligand (sPD-L1) levels were higher in patients with severe sepsis than in healthy volunteers, and have a predictive capacity for mortality. However, the role of serum soluble PD-1/PD-L1 in AP remains unclear. This study aimed to investigate whether the ICs of AP patients is associated with their sPD-1 and sPD-L1 levels, which were determined via enzyme-linked immunosorbent assay of peripheral blood samples from 63 MSAP and SAP patients and 30 healthy volunteers.Results: The serum sPD-1 levels in AP patients on days 1, 3 and 10 after onset were significantly increased in a time-dependent manner compared with that in healthy volunteers. Moreover, the AP patients with ICs had significantly higher serum sPD-1 levels than the AP patients without ICs. While serum sPD-L1 levels in AP patients were similar to that in healthy volunteers. Besides, serum levels of sPD-1/sPD-L1 10 were negatively correlated with circulating lymphocytes. Univariate and Multivariate regression analyses showed that the up-regulated serum sPD-1 level was an independent risk factor for ICs in AP. The area under the receiver operating characteristics (ROCs) curve indicated that combination with Acute Physiology and Chronic Health Evaluation II (APACHE II) score and serum sPD-1 level had a high accuracy in predicting ICs in AP patients.Conclusion: Serum sPD-1/sPD-L1 may be involved in the immunosuppressive process in AP. Moreover, the serum sPD-1 level may be an independent risk factor for predicting ICs in AP patients.

Morbid Obesity Is an Independent Risk Factor for AKI in Acute Pancreatitis

2015 ◽  
Vol 110 ◽  
pp. S30
Author(s):  
Carlos Roberto Simons-Linares ◽  
William Trick ◽  
Bashar M. Attar ◽  
Helen Zhang
Keyword(s):  
Morbid Obesity ◽  
Acute Pancreatitis ◽  
Risk Factor ◽  
Independent Risk Factor

14-3-3η Protein in Rheumatoid Arthritis: Promising Diagnostic Marker and Independent Risk Factor for Osteoporosis

2020 ◽  
Vol 51 (5) ◽  
pp. 529-539
Author(s):  
Tingting Zeng ◽  
Liming Tan ◽  
Yang Wu ◽  
Jianlin Yu
Keyword(s):  
Rheumatoid Arthritis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Logistic Regression Analysis ◽  
Independent Risk Factor ◽  
Multiple Logistic Regression Analysis ◽  
Area Under The Curve ◽  
Enzyme Linked Immunosorbent Assay ◽  
Disease Monitoring

Abstract Background Early identification and disease monitoring are challenges facing rheumatologists in the management of rheumatoid arthritis (RA). Methods We utilized enzyme-linked immunosorbent assay (ELISA) to determine 14-3-3η and anticyclic citrullinated peptide antibody (anti-CCP) levels, with rheumatoid factor (RF) level detected by rate nephelometry. The diagnostic value of each index was determined via receiver operating characteristic (ROC) curve, and the association between 14-3-3η and osteoporosis was assessed using multiple logistic regression analysis. Results Serum levels of 14-3-3η were 3.26 ng per mL in patients with RA. These levels were helpful in identifying patients with the disease, with the area under the curve (AUC) being 0.879 and 0.853, respectively, from all healthy control individuals and patients with RA. Combining 14-3-3η with RF or anti-CCP increased the diagnostic rate. Logistic regression analysis identified 14-3-3η as an independent risk factor for RA-related osteoporosis (odds ratio [OR], 1.503; 95% confidence interval [CI], 1.116–2.025; P <.01). Conclusions Serum 14-3-3η detection by itself or combined with other serum indices was helpful in differentiating patients with RA. Also, it was a promising biomarker for disease monitoring in RA.

scholarly journals Hypoalbuminemia, An Independent Risk Factor for Severity and Mortality Affects One Third of Patients in Acute Pancreatitis: Multicenter Prospective International Cohort Analysis

2021 ◽  
Author(s):  
Klementina Ocskay ◽  
Zsófia Vinkó ◽  
Dávid Németh ◽  
László Szabó ◽  
Judit Bajor ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Risk Factor ◽  
Organ Failure ◽  
Independent Risk Factor ◽  
Characteristic Curve ◽  
Cohort Analysis ◽  
Binary Logistic Regression ◽  
Receiver Operator Characteristic Curve ◽  
Local Complications ◽  
Group Data

Abstract Introduction The incidence and medical costs of acute pancreatitis (AP) are on the rise, and severe cases still have a 30% mortality rate. We aimed to evaluate hypoalbuminemia as a risk factor and the prognostic value of human serum albumin in AP. Methods Data of 2461 patients were extracted from the international, prospective, multicenter AP registry of the Hungarian Pancreatic Study Group. Data of patients with albumin measurement in the first 48 hours (n=1149) and anytime during hospitalization (n=1272) was analyzed. Multivariate binary logistic regression and Receiver Operator Characteristic curve analysis were used. Results The prevalence of hypoalbuminemia (<35g/L) was 19% on-admission and 35.7% during hospitalization. Hypoalbuminemia dose-dependently increased the risk of severity, mortality, local complications, and organ failure and is associated with longer hospital stay. The predictive value of hypoalbuminemia on-admission was poor for severity and mortality. Severe hypoalbuminemia (<25 g/L) was an independent risk factor for severity (OR: 48.761; CI:25.276-98.908) and mortality (OR:16.83; CI: 8.32-35.13). Albumin loss during AP was strongly associated with severity (p<0.001) and mortality (p=0.002).Conclusion Hypoalbuminemia is an independent risk factor of severity and mortality in AP, and it shows a dose-dependent relationship with local complications, organ failure, and length of stay.

scholarly journals Risk Factors for Acute Kidney Injury in Acute Pancreatitis: A 7-year Retrospective Analysis of Patients in a Large Tertiary Hospital

2020 ◽  
Author(s):  
Bingjun Yu ◽  
Wenhua He ◽  
Nonghua Lu
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Acute Pancreatitis ◽  
Risk Factor ◽  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Kidney Injury ◽  
Smoking History ◽  
Apache Ii Score ◽  
Lengths Of Stay

Abstract Background Acute kidney injury (AKI) is a serious complication of acute pancreatitis (AP) and causes a high risk of mortality. The aim of this study was to investigate the risk factors for AKI in patients in the early phase of AP.Methods In this retrospective observational study, 1655 AP patients were divided into an AKI and a non-AKI group. Age, sex, BMI, APACHE II score, smoking history, hypertriglyceridaemia (HTG), alcohol abuse, biliary disease, organ failure, pancreatic necrosis and necrosis debridement were collected from the hospital record database.Results 1036 males (62.6%) and 619 females (37.4%) were enrolled in this study. 1255 and 430 AP patients were included in the non-AKI and AKI groups, respectively. The mean age was 45.90±11.73 years. Hospital and intensive care unit (ICU) lengths of stay were 18.13±43.26 and 31.53±72.47 days, respectively. The incidence of organ failure and pancreatic necrosis were 25.0% and 32.2%, respectively. The morbidity of percutaneous catheter drainage (PCD) and operative necrosectomy (ON) was 10.9%, and the mortality among AP patients was 6.3%. HTG was identified as a risk factor for AKI in AP (P=0.001). The incidence of organ failure (P=0.001), pancreatic necrosis (P=0.001) and necrosis debridement were greater in the AKI group than those in the non-AKI group.Conclusions HTG is an independent risk factor for AKI in AP. AP patients with AKI have adverse outcomes such as high rates of organ failure, pancreatic necrosis, and necrosis debridement and longer hospital and ICU lengths of stay.

scholarly journals Intra-Abdominal Pressure, a Prognostic Marker in the Evolution of Acute Pancreatitis

2019 ◽  
Vol 24 (4) ◽  
pp. 51-55
Author(s):  
Alina Simona Bereanu ◽  
Bogdan Vintilă ◽  
Mihai Sava
Keyword(s):  
Acute Pancreatitis ◽  
Prognostic Marker ◽  
Clinical Laboratory ◽  
Apache Ii ◽  
Prognostic Scores ◽  
Apache Ii Score ◽  
Abdominal Pressure ◽  
Operating Characteristics ◽  
Specificity And Sensitivity ◽  
Ranson Score

Abstract In acute pancreatitis some prognostic scores have been suggested, based on clinical, laboratory and radiological criteria. The most popular are: Ranson score, APACHE II score and CT severity index (CTSI). The trend is to find a prognostic marker that is easy to use, cheap, and reproductible. Recently, the increase of the intra-abdominal pressure (IAP) has drawn attention. Material and Methods: From January 2012 to April 2014, a group of 64 patients, admitted to the Clinical Department of Anaesthesia and Intensive Care and the Surgical Departments of the SCJU Sibiu, with the diagnosis of acute pancreatitis, were included in this observational prospective study. The cut-off values, the specificity and sensitivity of the prognostic scores were calculated using the receiver operating characteristics (ROC) analysis curves. Results: At a cut-off value of 12 mm Hg IAP max has a sensitivity of 0,75, similar to Ranson score at 48 h (0.72 at a cut-off value 3) and CTSI (0,73 at a cut-off value 4). Better results are just for APACHE II score at 24 h (0,88 at a cut-off value 8). IAP max has a specificity of 0,88, simillary to CTSI (0,83) and APACHE II score (0,82). Conclusions: In our study maximum IAP could be correlated with prognostic markers for severe evolution in acute pancreatitis.

scholarly journals Hypoalbuminemia affects one third of acute pancreatitis patients and is independently associated with severity and mortality

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Klementina Ocskay ◽  
Zsófia Vinkó ◽  
Dávid Németh ◽  
László Szabó ◽  
Judit Bajor ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Risk Factor ◽  
Organ Failure ◽  
Independent Risk Factor ◽  
Characteristic Curve ◽  
Binary Logistic Regression ◽  
Receiver Operator Characteristic Curve ◽  
Local Complications ◽  
Dependent Relationship ◽  
Group Data

AbstractThe incidence and medical costs of acute pancreatitis (AP) are on the rise, and severe cases still have a 30% mortality rate. We aimed to evaluate hypoalbuminemia as a risk factor and the prognostic value of human serum albumin in AP. Data from 2461 patients were extracted from the international, prospective, multicentre AP registry operated by the Hungarian Pancreatic Study Group. Data from patients with albumin measurement in the first 48 h (n = 1149) and anytime during hospitalization (n = 1272) were analysed. Multivariate binary logistic regression and Receiver Operator Characteristic curve analysis were used. The prevalence of hypoalbuminemia (< 35 g/L) was 19% on admission and 35.7% during hospitalization. Hypoalbuminemia dose-dependently increased the risk of severity, mortality, local complications and organ failure and is associated with longer hospital stay. The predictive value of hypoalbuminemia on admission was poor for severity and mortality. Severe hypoalbuminemia (< 25 g/L) represented an independent risk factor for severity (OR 48.761; CI 25.276–98.908) and mortality (OR 16.83; CI 8.32–35.13). Albumin loss during AP was strongly associated with severity (p < 0.001) and mortality (p = 0.002). Hypoalbuminemia represents an independent risk factor for severity and mortality in AP, and it shows a dose-dependent relationship with local complications, organ failure and length of stay.

Why is Obesity an Independent Risk Factor for Severity in Patients with Acute Pancreatitis?

2009 ◽  
Vol 104 ◽  
pp. S66
Author(s):  
Ian Wall ◽  
Nison Badalov ◽  
Rabin Rahmani ◽  
Jack Braha ◽  
Darshan Patel ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Risk Factor ◽  
Independent Risk Factor

A murine model of obesity implicates the adipokine milieu in the pathogenesis of severe acute pancreatitis

2008 ◽  
Vol 295 (3) ◽  
pp. G552-G558 ◽  
Author(s):  
Nicholas J. Zyromski ◽  
Abhishek Mathur ◽  
Henry A. Pitt ◽  
Debao Lu ◽  
John T. Gripe ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Adipose Tissue ◽  
Risk Factor ◽  
Inflammatory Response ◽  
Proinflammatory Cytokines ◽  
Murine Model ◽  
Independent Risk Factor ◽  
Obese Mice ◽  
Wild Type ◽  
Adipose Tissue Volume

Obesity is clearly an independent risk factor for increased severity of acute pancreatitis (AP), although the mechanisms underlying this association are unknown. Adipokines (including leptin and adiponectin) are pleiotropic molecules produced by adipocytes that are important regulators of the inflammatory response. We hypothesized that the altered adipokine milieu observed in obesity contributes to the increased severity of pancreatitis. Lean (C57BL/6J), obese leptin-deficient (LepOb), and obese hyperleptinemic (LepDb) mice were subjected to AP by six hourly intraperitoneal injections of cerulein (50 μg/kg). Severity of AP was assessed by histology and by measuring pancreatic concentration of the proinflammatory cytokines IL-1β and IL-6, the chemokine MCP-1, and the marker of neutrophil activation MPO. Both congenitally obese strains of mice developed significantly more severe AP than wild-type lean animals. Severity of AP was not solely related to adipose tissue volume: LepOb mice were heaviest; however, LepDb mice developed the most severe AP both histologically and biochemically. Circulating adiponectin concentrations inversely mirrored the severity of pancreatitis. These data demonstrate that congenitally obese mice develop more severe AP than lean animals when challenged by cerulein hyperstimulation and suggest that alteration of the adipokine milieu exacerbates the severity of AP in obesity.

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