Serum levels of apolipoprotein A-I and high-density lipoprotein can predict organ failure in acute pancreatitis

详细信息    查看全文

• 作者：Yun-Shing Peng (1) (9)
  Yung-Chang Chen (2) (9)
  Ya-Chung Tian (2) (9)
  Chih-Wei Yang (2) (9)
  Jau-Min Lien (3) (9)
  Ji-Tseng Fang (2) (9)
  Cheng-Shyong Wu (4) (9)
  Chien-Fu Hung (5) (9)
  Tsan-Long Hwang (6) (9)
  Ying-Huang Tsai (7) (9)
  Mel S Lee (8) (9)
  Ming-Hung Tsai (10) (3) (9)
  
  1. Division of Endocrinology and Metabolism ; Chang Gung Memorial Hospital ; 6 ; West Section ; Chia-Pu Road ; Chia-Yi ; Taiwan
  9. Chang Gung University ; College of Medicine ; 259 ; Wen-Hwa 1st Road ; Kwei-Shan ; Tao-Yuan ; Taiwan
  2. Division of Critical Care Nephrology ; Chang Gung Memorial Hospital ; 199 ; Tung-Hwa North Road ; Taipei ; Taiwan
  3. Division of Digestive Therapeutic Endoscopy ; Chang Gung Memorial Hospital ; 199 ; Tung-Hwa North Road ; Taipei ; Taiwan
  4. Division of Gastroenterology ; Chang Gung Memorial Hospital ; 6 ; West Section ; Chia-Pu Road ; Chia-Yi ; Taiwan
  5. Department of Radiology ; Chang Gung Memorial Hospital ; 199 ; Tung-Hwa North Road ; Taipei ; Taiwan
  6. Division of General Surgery ; Chang Gung Memorial Hospital ; 199 ; Tung-Hwa North Road ; Taipei ; Taiwan
  7. Division of Thoracic and Critical Care Medicine ; Chang Gung Memorial Hospital ; 6 ; West Section ; Chia-Pu Road ; Chia-Yi ; Taiwan
  8. Department of Surgery ; Chang Gung Memorial Hospital ; 6 ; West Section ; Chia-Pu Road ; Chia-Yi ; Taiwan
  10. Division of Gastroenterology and Hepatology ; Chang Gung Memorial Hospital ; Chang Gung University ; 199 ; Tung-Hwa North Road ; Taipei ; 105 ; Taiwan
  
• 刊名：Critical Care
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：19
• 期：1
• 全文大小：442 KB
• 参考文献：1. Waele, JJ (2014) Acute pancreatitis. Curr Opin Crit Care. 2: pp. 189-95 CrossRef
  2. McKay, CJ, Curran, F, Sharples, C, Baxter, JN, Imrie, CW (1997) Prospective placebo-controlled randomized trial of lexipafant in predicted severe acute pancreatitis. Br J Surg. 84: pp. 1239-43 CrossRef
  3. Uhl, W, Buchler, MW, Malfertheiner, P, Beger, HG, Adler, G, Gaus, W (1999) A randomised, double blind, multicentre trial of octreotide in moderate to severe acute pancreatitis. Gut. 45: pp. 97-104 CrossRef
  4. Tenner, S, Sica, G, Hughes, M, Noordhoek, E, Feng, S, Zinner, M (1997) Relationship of necrosis to organ failure in severe acute pancreatitis. Gastroenterology. 113: pp. 899-903 CrossRef
  5. Johnson, CD, Kingsnorth, AN, Imrie, CW, McMahon, MJ, Neoptolemos, JP, McKay, C (2001) Double blind, randomised, placebo controlled study of a platelet activating factor antagonist, lexipafant, in the treatment and prevention of organ failure in predicted severe acute pancreatitis. Gut. 48: pp. 62-9 CrossRef
  6. Buter, A, Imrie, CW, Carter, CR, Evans, S, McKay, CJ (2002) Dynamic nature of early organ dysfunction determines outcome in acute pancreatitis. Br J Surg. 89: pp. 298-302 CrossRef
  7. Johnson, CD, Abu-Hilal, M (2004) Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis. Gut. 53: pp. 1340-4 CrossRef
  8. Banks, PA, Bollen, TL, Dervenis, C, Gooszen, HG, Johnson, CD, Sarr, MG (2013) Classification of acute pancreatitis鈥?012: revision of the Atlanta classification and definitions by international consensus. Gut. 62: pp. 102-11 CrossRef
  9. Dellinger, EP, Forsmark, CE, Layer, P, L茅vy, P, Marav铆-Poma, E, Petrov, MS (2012) Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. Ann Surg. 256: pp. 875-80 CrossRef
  10. Alvarez, C, Ramos, A (1986) Lipids, lipoproteins, and apoproteins in serum during infection. Clin Chem. 32: pp. 142-5
  11. Chenaud, C, Merlani, PG, Roux-Lombard, P, Burger, D, Harbarth, S, Luyasu, S (2004) Low apolipoprotein A-I level at intensive care unit admission and systemic inflammatory response syndrome exacerbation. Crit Care Med. 32: pp. 632-7 CrossRef
  12. Leeuwen, HJ, Heezius, EC, Dallinga, GM, Strijp, JA, Verhoef, J, Kessel, KP (2003) Lipoprotein metabolism in patients with severe sepsis. Crit Care Med. 31: pp. 1359-66 CrossRef
  13. Emancipator, K, Csako, G, Elin, RJ (1992) In vitro inactivation of bacterial endotoxin by human lipoproteins and apolipoproteins. Infect Immun. 60: pp. 596-601
  14. Flegel, WA, Baumstark, MW, Weinstock, C, Berg, A, Northoff, H (1993) Prevention of endotoxin-induced monokine release by human low- and high-density lipoproteins and by apolipoprotein A-I. Infect Immun. 61: pp. 5140-6
  15. Ettinger, WH, Varma, VK, Sorci-Thomas, M, Parks, JS, Sigmon, RC, Smith, TK (1994) Cytokines decrease apolipoprotein accumulation in medium from Hep G2 cells. Arterioscler Thromb. 14: pp. 8-13 CrossRef
  16. Khan, J, Solakivi, T, Sepp盲nen, H, Lappalainen-Lehto, R, J盲rvinen, S, Ronkainen, J (2012) Serum lipid and fatty acid profiles are highly changed in patients with alcohol induced acute pancreatitis. Pancreatology. 12: pp. 44-8 CrossRef
  17. Khan, J, Nordback, I, Sand, J (2013) Serum lipid levels are associated with the severity of acute pancreatitis. Digestion. 87: pp. 223-8 CrossRef
  18. Bugdaci, MS, Sokmen, M, Zuhur, SS, Altuntas, Y (2011) Lipid profile changes and importance of low serum 伪-lipoprotein fraction (high-density lipoprotein) in cases with acute pancreatitis. Pancreas. 40: pp. 1241-4 CrossRef
  19. Bradley, EL (1993) A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg 128: pp. 586-90 CrossRef
  20. Marshall, JC, Cook, DJ, Christou, NV, Bernard, GR, Sprung, CL, Sibbald, WJ (1995) Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 23: pp. 1638-52 CrossRef
  21. Singh, VK, Wu, BU, Bollen, TL, Repas, K, Maurer, R, Mortele, KJ (2009) Early systemic inflammatory response syndrome is associated with severe acute pancreatitis. Clin Gastroenterol Hepatol. 7: pp. 1247-51 CrossRef
  22. Vincent, JL, Moreno, R, Takala, J, Willatts, S, Mendonca, A, Bruining, H (1996) The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the working group on sepsis-related problems of the European Society of Intensive Care Medicine. Intensive Care Med 22: pp. 707-10 CrossRef
  23. Youden, WJ (1950) Index for rating diagnosis tests. Cancer. 3: pp. 32-5 CrossRef
  24. Hanley, JA, McNeil, BJ (1983) A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology. 148: pp. 839-48 CrossRef
  25. Sch眉tte, K, Malfertheiner, P (2008) Markers for predicting severity and progression of acute pancreatitis. Best Pract Res Clin Gastroenterol. 22: pp. 75-90 CrossRef
  26. Beger, HG, Rau, BM (2007) Severe acute pancreatitis: Clinical course and management. World J Gastroenterol. 13: pp. 5043-51
  27. Ammori, BJ, Leeder, PC, King, RF, Barclay, GR, Martin, IG, Lavin, M (1999) Early increase in intestinal permeability in patients with severe acute pancreatitis: correlation with endotoxemia, organ failure, and mortality. J Gastrointest Surg. 3: pp. 252-62 CrossRef
  28. Levels, JH, Abraham, PR, Ende, A, Deventer, SJ (2001) Distribution and kinetics of lipoprotein-bound endotoxin. Infect Immun. 69: pp. 2821-8 CrossRef
  29. Murch, O, Collin, M, Hinds, CJ, Thiemermann, C (2007) Lipoproteins in inflammation and sepsis. I. Basic science. Intensive Care Med. 33: pp. 13-24 CrossRef
  30. Unal, E, Uzun, H, Kusaslan, R, Dogan, M, Genc, H, Gunes, P (2005) Serum paraoxonase (a high-density lipoprotein-associated lipophilic antioxidant) activity and lipid profile in experimental acute pancreatitis. Pancreas. 31: pp. 84-7 CrossRef
  31. Leung, PS, Chan, YC (2009) Role of oxidative stress in pancreatic inflammation. Antioxid Redox Signal. 11: pp. 135-65 CrossRef
  32. Chien, JY, Jerng, JS, Yu, CJ, Yang, PC (2005) Low serum level of high-density lipoprotein cholesterol is a poor prognostic factor for severe sepsis. Crit Care Med. 33: pp. 1688-93 CrossRef
  33. Gordon, BR, Parker, TS, Levine, DM, Saal, SD, Wang, JC, Sloan, BJ (2001) Relationship of hypolipidemia to cytokine concentrations and outcomes in critically ill surgical patients. Crit Care Med. 29: pp. 1563-8 CrossRef
  34. Tsai, MH, Peng, YS, Chen, YC, Lien, JM, Tian, YC, Fang, JT (2009) Low serum concentration of apolipoprotein A-I is an indicator of poor prognosis in cirrhotic patients with severe sepsis. J Hepatol. 50: pp. 906-15 CrossRef
  35. Tietge, UJ, Maugeais, C, Lund-Katz, S, Grass, D (2002) deBeer FC, Rader DJ. Human secretory phospholipase A2 mediates decreased plasma levels of HDL cholesterol and apoA-I in response to inflammation in human apoA-I transgenic mice. Arterioscler Thromb Vasc Biol. 22: pp. 1213-8 CrossRef
  36. Mounzer, R, Langmead, CJ, Wu, BU, Evans, AC, Bishehsari, F, Muddana, V (2012) Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis. Gastroenterology. 142: pp. 1476-82 CrossRef
  37. Wu, BU, Bakker, OJ, Papachristou, GI, Besselink, MG, Repas, K, Santvoort, HC (2011) Blood urea nitrogen in the early assessment of acute pancreatitis: an international validation study. Arch Intern Med. 171: pp. 669-76 CrossRef
  38. Muddana, V, Whitcomb, DC, Khalid, A, Slivka, A, Papachristou, GI (2009) Elevated serum creatinine as a marker of pancreatic necrosis in acute pancreatitis. Am J Gastroenterol. 104: pp. 164-70 CrossRef
  
• 刊物主题：Intensive / Critical Care Medicine; Emergency Medicine;
• 出版者：BioMed Central
• ISSN：1364-8535

文摘

Introduction Predicting severity of pancreatitis is an important goal. Clinicians are still searching for novel and simple biomarkers that can better predict persistent organ failure (OF). Lipoproteins, especially high-density lipoprotein (HDL), and apolipoprotein A-I (APO A-I), have been shown to have anti-inflammation effects in various clinical settings. Severe acute pancreatitis (SAP) is associated with hypo-lipoproteinemia. We studied whether the concentrations of HDL and APO A-I can predict persistent OF in patients with predicted SAP admitted to the ICU. Methods In 66 patients with predicted SAP, we prospectively evaluated the relationship between lipid levels, inflammatory cytokines and clinical outcomes, including persistent OF and hospital mortality. Blood samples were obtained within 24聽hours of admission to the ICU. Results HDL and APO A-I levels were inversely correlated with various disease severity scores. Patients with persistent OF had lower levels of HDL and APO A-I, while those with transient OF had lower levels of interleukin-6, tumor necrosis factor-伪 and lower rates of hospital mortality. Meanwhile, hospital non-survivors had lower concentrations of HDL, and APO A-I compared to the survivors. By using the area under the receiver operating characteristic (AUROC) curve, both HDL and APO A-I demonstrated an excellent discriminative power for predicting persistent OF among all patients (AUROC 0.912 and 0.898 respectively) and among those with OF (AUROC 0.904 and 0.895 respectively). Pair-wise comparison of AUROC showed that both HDL and APO A-I had better discriminative power than C-reactive protein to predict persistent OF. Conclusions Serum levels of HDL and APO A-I at admission to the ICU are inversely correlated with disease severity in patients with predicted SAP and can predict persistent OF in this clinical setting.