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