1
|
Han X, Ni J, Li B, Bao J, Wan R, Hu G, Chen C. Predictive value of serum retinol binding protein in severity and complications of acute pancreatitis: a retrospective cohort study. Scand J Gastroenterol 2024; 59:92-99. [PMID: 37608609 DOI: 10.1080/00365521.2023.2249570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVES Retinol binding protein (RBP) is associated with an increased risk of insulin resistance, metabolic syndrome, atherosclerosis and hypertension. This study aimed to evaluate serum RBP levels in patients with acute pancreatitis (AP). METHODS The study included 1,871 AP patients, including 1,411 with mild AP (MAP), 244 with moderately severe AP (MSAP), and 186 with severe AP (SAP). Retrospective analysis was conducted on RBP concentrations and other clinical data of AP patients. RESULTS AP patients were subgrouped by RBP level into low RBP (LRBP), normal RBP (NRBP), and high RBP (HRBP) groups. The LRBP group showed a significantly higher proportion of SAP patients than NRBP and HRBP groups. Additionally, the LRBP group had the highest BISAP and CTSI scores among the three groups; WBC and CRP levels in the NRBP group were significantly lower than those in the LRBP and HRBP groups. RBP was better at predicting acute necrotic collection (ANC) than other local complications, with an area under the curve (AUC) of 0.821. RBP was also an independent risk factor for acute lung injury (ALI) and ANC in AP patients. The AUC of RBP for predicting ALI was 0.829, with 30.45 mg/L as the optimal cutoff value, and the sensitivity and specificity were 59.70% and 96.50%, respectively. The AUC of RBP for predicting ANC was 0.821, with 28.35 mg/L as the optimal cutoff value, and the sensitivity and specificity were 61.20% and 95.50%, respectively. CONCLUSIONS Serum RBP had predictive value for AP severity, local and systemic complications.
Collapse
Affiliation(s)
- Xiao Han
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Pancreatic Disease, Institute of Pancreatic Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianbo Ni
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Pancreatic Disease, Institute of Pancreatic Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Li
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Pancreatic Disease, Institute of Pancreatic Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingpiao Bao
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Pancreatic Disease, Institute of Pancreatic Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Wan
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Pancreatic Disease, Institute of Pancreatic Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guoyong Hu
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Pancreatic Disease, Institute of Pancreatic Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Congying Chen
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Pancreatic Disease, Institute of Pancreatic Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
2
|
Ding M, Wang R, Xu H, Li M, Zhou T, Li Y, Gao Y, Gu X. The clinical characteristics of focal acute pancreatitis based on imaging diagnosis: comparison with non-localized acute pancreatitis- a preliminary result. BMC Gastroenterol 2023; 23:380. [PMID: 37946168 PMCID: PMC10634076 DOI: 10.1186/s12876-023-03015-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Focal acute pancreatitis is a special type of acute pancreatitis, which diagnosis is based on image showing a focal mass formation in the pancreas. For acute pancreatitis with or without focal inflammatory enlargement, little is known on differences between them. Our purpose was to find differences between focal acute pancreatitis and non-localized acute pancreatitis. METHODS We reviewed the medical records of a total of 24 patients diagnosed with focal acute pancreatitis by imaging and clinical diagnosis, and 27 cases of acute pancreatitis which manifest non-localized pancreas inflammation were selected as the control group. The differences of the two groups were compared to describe their clinical characteristics. RESULTS Differences in bloating (4.2% VS 29.6%,P = 0.026), abdominal tenderness (58.3% VS 85.2%,P = 0.032), peripheral blood neutrophil ratio (60.1 ± 23.3VS 75.9 ± 12.6,P = 0.004), serum D-Dimer (0.40(0.25,0.98) VS 1.59(0.49,4.63),P = 0.008), serum GGT (40(25,91) VS120(22,383),P = 0.046), serum amylase(435(241,718) VS 591(394,1333),P = 0.044) and lipase(988(648,1067) VS 1686(525,2675),P = 0.027) between focal acute pancreatitis and non-localized acute pancreatitis groups were statistically significant. However, difference of the severity of two groups was not statistically significant (P = 1.000). CONCLUSION Compared with non-localized acute pancreatitis, changes in symptoms, signs and laboratory indicators of focal acute pancreatitis are non-obvious, however, there was no significant difference in the severity of two groups, indicating that we should pay more attention to diagnosis of focal acute pancreatitis in clinical practice.
Collapse
Affiliation(s)
- Mengmeng Ding
- Department of Gastroenterology, Qilu Hospital of Shandong University, Wenhua Xi Rd, 107, Jinan, Shandong, 250012, People's Republic of China
| | - Renren Wang
- Department of Gastroenterology, Qilu Hospital of Shandong University, Wenhua Xi Rd, 107, Jinan, Shandong, 250012, People's Republic of China
| | - Huawei Xu
- Department of Gastroenterology, Qilu Hospital of Shandong University, Wenhua Xi Rd, 107, Jinan, Shandong, 250012, People's Republic of China
| | - Meng Li
- Department of Gastroenterology, Qilu Hospital of Shandong University, Wenhua Xi Rd, 107, Jinan, Shandong, 250012, People's Republic of China
| | - Tao Zhou
- Department of Geriatric Medicine, Qilu Hospital of Shandong University, Wenhua Xi Rd, 107, Jinan, Shandong, 250012, People's Republic of China
| | - Yueyue Li
- Department of Gastroenterology, Qilu Hospital of Shandong University, Wenhua Xi Rd, 107, Jinan, Shandong, 250012, People's Republic of China
| | - Yanjing Gao
- Department of Gastroenterology, Qilu Hospital of Shandong University, Wenhua Xi Rd, 107, Jinan, Shandong, 250012, People's Republic of China
| | - Xiaomeng Gu
- Department of Gastroenterology, Qilu Hospital of Shandong University, Wenhua Xi Rd, 107, Jinan, Shandong, 250012, People's Republic of China.
| |
Collapse
|
3
|
Dong XW, Wei M, Ma N, Lu YY, Xie XC, Shi XL, Dong J, Ma XJ, Li BQ, Tong ZH, Li WQ. Decreased circulating retinol binding protein is an independent risk factor for local complications of acute pancreatitis. Shijie Huaren Xiaohua Zazhi 2021; 29:873-879. [DOI: 10.11569/wcjd.v29.i15.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute pancreatitis is a common acute abdomen in China. There is a decrease of serum retinol-binding protein (RBP) in some patients, but its clinical significance is not clear.
AIM To explore the relationship between serum RBP and the severity and complications of AP.
METHODS The clinical data of AP patients admitted to Jinling Hospital in 2018 within 7 days of onset were analyzed retrospectively. The enrolled patients were divided into either a normal RBP (NRBP) group or a low RBP (LRBP) group according to the serum RBP level. The baseline characteristics, severity, and prognosis of disease were compared between the two groups. Logistic regression analysis was used to explore the independent risk factors for local complications. Receiver operating characteristic (ROC) curve was drawn to evaluate the performance of serum RBP in predicting complications.
RESULTS A total of 176 patients were enrolled, including 41 in the NRBP group and 135 in the LRBP group. The severity of AP in the LRBP group was significantly more severe than that of the NRBP group (MAP: 15.6% vs 39.0%, MSAP: 53.3% vs 29.3%, SAP: 31.1% vs 31.7%; P < 0.05). The incidence of acute necrotic collection was 70.4% in the LRBP group, significantly higher than that (52.1%) of the NRBP group (P < 0.05). The serum level of RBP in patients with local complications was significantly lower than that in patients without (24.00 (15.00, 27.50) mg/L vs 12.00 (9.00, 22.00) mg/L, P < 0.05). The AUC of serum RBP for predicting local complications was 0.708 (95%CI: 0.615-0.801) and the cut-off value was 15.5 mg/L with a sensitivity 60.4% and specificity 75.7%. The decrease of serum RBP was an independent risk factor for local complications (OR = 5.306, P = 0.003, 95%CI: 1.771-15.896).
CONCLUSION The level of serum RBP in the acute phase could predict the occurrence of local complications of AP, but has no significant correlation with systemic inflammatory response and remote organ failure.
Collapse
Affiliation(s)
- Xiao-Wu Dong
- Department of Critical Care Medicine, Jinling Clinical Medical College of Nanjing Medical University, Nanjing 210002, Jiangsu Province, China
| | - Mei Wei
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Nan Ma
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Ying-Ying Lu
- Department of Critical Care Medicine, Jinling Clinical Medical College of Southeast University, Nanjing 210002, Jiangsu Province, China
| | - Xiao-Chun Xie
- Department of Critical Care Medicine, Jinling Clinical Medical College of Southeast University, Nanjing 210002, Jiangsu Province, China
| | - Xiao-Lei Shi
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Jie Dong
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Xiao-Jie Ma
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Bai-Qiang Li
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Zhi-Hui Tong
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Wei-Qin Li
- Department of Critical Care Medicine, Jinling Clinical Medical College of Nanjing Medical University, Nanjing 210002, Jiangsu Province, China
| |
Collapse
|