Pablo Ortega-Deballon1,2, Louise Ménégaut3, Isabelle Fournel4, David Orry5, David Masson3,2, Christine Binquet4,2, Olivier Facy1,2. 1. 1 Department of Digestive Surgery, Clinical Epidemiology/Clinical Trials, University Hospital of Dijon , Dijon, France . 2. 4 INSERM, U866, Dijon, France; University of Burgundy , School of Health, Dijon, France . 3. 2 Department of Biochemistry, Clinical Epidemiology/Clinical Trials, University Hospital of Dijon , Dijon, France . 4. 3 Department of Clinical Investigation Centre, Clinical Epidemiology/Clinical Trials, University Hospital of Dijon , Dijon, France . 5. 5 Department of Surgical Oncology, Georges-François Leclerc Anticancer Centre , Dijon, France .
Abstract
BACKGROUND: Infections are the most frequent complication after colorectal surgery. It has been suggested that adipose tissue metabolism could be related to the risk of post-operative infection, but this could be partially related to the body-mass index. The aim of this study was to look for a relation between adipocytokine levels and the risk of post-operative infection and its type. METHODS: This prospective cohort study was conducted between March 2013 and March 2014 in two French teaching hospitals. Pre-operative plasma levels of adiponectin and leptin were measured in consecutive patients undergoing elective colorectal surgery. All infections in the 30 d following surgery were recorded. RESULTS: Among the 142 patients included, 29 (20.4%) presented a post-operative infection: 26 surgical site infections and three extra-abdominal infections. Adiponectin and leptin levels correlated weakly but substantially with the body mass index (rspearman=-0.26 and +0.31, respectively). While there was no substantial difference between patients with and those without post-operative infection for adiponectin, median pre-operative leptin was substantially greater in patients with post-operative infection (8.67 vs. 4.37 ng/mL, p=0.003). A substantial interaction was found between leptin and cancer. In patients operated on for cancer, the area under the receiver-operating characteristic (ROC) curve was lower than in patients with benign diseases (0.597 vs. 0.858, p=0.011). Similar results were observed for intra-abdominal infection and surgical site infection. CONCLUSION: Patients with greater levels of leptin before colorectal surgery have an increased risk of post-operative surgical infection. This effect is stronger in patients without cancer. Adiponectin levels are not related to the risk of infection in Western patients.
BACKGROUND:Infections are the most frequent complication after colorectal surgery. It has been suggested that adipose tissue metabolism could be related to the risk of post-operative infection, but this could be partially related to the body-mass index. The aim of this study was to look for a relation between adipocytokine levels and the risk of post-operative infection and its type. METHODS: This prospective cohort study was conducted between March 2013 and March 2014 in two French teaching hospitals. Pre-operative plasma levels of adiponectin and leptin were measured in consecutive patients undergoing elective colorectal surgery. All infections in the 30 d following surgery were recorded. RESULTS: Among the 142 patients included, 29 (20.4%) presented a post-operative infection: 26 surgical site infections and three extra-abdominal infections. Adiponectin and leptin levels correlated weakly but substantially with the body mass index (rspearman=-0.26 and +0.31, respectively). While there was no substantial difference between patients with and those without post-operative infection for adiponectin, median pre-operative leptin was substantially greater in patients with post-operative infection (8.67 vs. 4.37 ng/mL, p=0.003). A substantial interaction was found between leptin and cancer. In patients operated on for cancer, the area under the receiver-operating characteristic (ROC) curve was lower than in patients with benign diseases (0.597 vs. 0.858, p=0.011). Similar results were observed for intra-abdominal infection and surgical site infection. CONCLUSION:Patients with greater levels of leptin before colorectal surgery have an increased risk of post-operative surgical infection. This effect is stronger in patients without cancer. Adiponectin levels are not related to the risk of infection in Western patients.
Authors: Luigi De Magistris; Brice Paquette; David Orry; Olivier Facy; Giovanni Di Giacomo; Patrick Rat; Christine Binquet; Pablo Ortega-Deballon Journal: Int J Colorectal Dis Date: 2016-06-29 Impact factor: 2.571
Authors: Gaurav Sharma; Rohan Kulkarni; Samir K Shah; William W King; Alban Longchamp; Ming Tao; Kui Ding; C Keith Ozaki Journal: Surgery Date: 2016-04-14 Impact factor: 3.982
Authors: David P J van Dijk; Maikel J A M Bakens; Mariëlle M E Coolsen; Sander S Rensen; Ronald M van Dam; Martijn J L Bours; Matty P Weijenberg; Cornelis H C Dejong; Steven W M Olde Damink Journal: J Cachexia Sarcopenia Muscle Date: 2016-10-26 Impact factor: 12.910