Qing Huang1, Zhe Wu1, Cheng Chi2, Chunbo Wu2, Lin Su1, Yuanyuan Zhang1, Jihong Zhu2, Yulan Liu3. 1. Department of Gastroenterology, Peking University People's Hospital, Beijing, China. 2. Department of Emergency, Peking University People's Hospital, Beijing, China. 3. Department of Gastroenterology, Peking University People's Hospital, Beijing, China. liuyulan@pkuph.edu.cn.
Abstract
BACKGROUNDS: Angiopoietin-2 (Ang-2) is a new predictor for acute pancreatitis (AP). AIMS: To assess the predictive value of Ang-2 in determining the progress of AP and the subsequent acute gastrointestinal injury (AGI). METHODS: This was a prospective study that enrolled 170 patients with AP and 100 healthy controls. Blood samples were collected within 24 h of the onset of AP. RESULTS: The majority (108) of the patients were categorized as having MAP with the rest (62) classified as suffering from SAP. Considering AGI grading, there were 118 grade 1 and 12 grade 4 patients; in grades 2 and 3, there were 20 patients each. AP was accompanied by MODS and pancreatic necrosis in 46 and 24 cases, respectively. Eighty patients were admitted to the ICU, while mortality was reported among 7.1% patients. The plasma Ang-2 levels were higher among patients with AP than in controls. A similar trend prevailed, in patients with SAP compared to those with MAP. Ang-2 was significantly increased from AGI grade 1 through to grade 4, showing a desirable positive predictive accuracy. Moreover, Ang-2 also showed strong correlations with intestinal permeability as evaluated by d-lactate (DLA), diamine oxidase (DAO), and intestinal fatty acid binding proteins (I-FABPs). Tools (Ranson and APACHE II scores, CRP), which are used more conventionally, could not effectively distinguish the various grades of AGI. Furthermore, Ang-2 predicted poor prognosis and adverse outcomes, including mortality, among patients with AP. CONCLUSIONS: This study showed Ang-2 to be an accurate early predictor for SAP, AGI, and intestinal barrier dysfunction, outperforming conventional biomarkers. Ang-2 levels also predicted the adverse outcomes and mortality due to AP.
BACKGROUNDS: Angiopoietin-2 (Ang-2) is a new predictor for acute pancreatitis (AP). AIMS: To assess the predictive value of Ang-2 in determining the progress of AP and the subsequent acute gastrointestinal injury (AGI). METHODS: This was a prospective study that enrolled 170 patients with AP and 100 healthy controls. Blood samples were collected within 24 h of the onset of AP. RESULTS: The majority (108) of the patients were categorized as having MAP with the rest (62) classified as suffering from SAP. Considering AGI grading, there were 118 grade 1 and 12 grade 4 patients; in grades 2 and 3, there were 20 patients each. AP was accompanied by MODS and pancreatic necrosis in 46 and 24 cases, respectively. Eighty patients were admitted to the ICU, while mortality was reported among 7.1% patients. The plasma Ang-2 levels were higher among patients with AP than in controls. A similar trend prevailed, in patients with SAP compared to those with MAP. Ang-2 was significantly increased from AGI grade 1 through to grade 4, showing a desirable positive predictive accuracy. Moreover, Ang-2 also showed strong correlations with intestinal permeability as evaluated by d-lactate (DLA), diamine oxidase (DAO), and intestinal fatty acid binding proteins (I-FABPs). Tools (Ranson and APACHE II scores, CRP), which are used more conventionally, could not effectively distinguish the various grades of AGI. Furthermore, Ang-2 predicted poor prognosis and adverse outcomes, including mortality, among patients with AP. CONCLUSIONS: This study showed Ang-2 to be an accurate early predictor for SAP, AGI, and intestinal barrier dysfunction, outperforming conventional biomarkers. Ang-2 levels also predicted the adverse outcomes and mortality due to AP.
Authors: Na Shi; Lan Lan; Jiawei Luo; Ping Zhu; Thomas R W Ward; Peter Szatmary; Robert Sutton; Wei Huang; John A Windsor; Xiaobo Zhou; Qing Xia Journal: J Pers Med Date: 2022-04-11