Serum Leptin and Ghrelin Levels in Patients in the Early Stages of Acute Biliary Pancreatitis and Different Degrees of Severity

Panek, Józefa; Bonior, Joanna; Pieton, J.; Jaworek, Jolanta

doi:10.2478/pjs-2014-0038

Cited by 11 publications

(8 citation statements)

References 20 publications

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“…Although in some other clinical studies the prognostic value of leptin on pancreatic necrosis was proven [23], according to our data leptin is not suitable for predicting SAP, development of necrosis, need for interventions and mortality. However, this data replicates the results of some previously published studies [24, 32, 33]. …”

Section: Discussionsupporting

confidence: 92%

“…The significant differences of resistin, visfatin, leptin and adiponectin concentrations between mild AP (MAP) and SAP patients were found in some older studies, but all of them were very different in their methodology, diagnostic criteria, classification and evaluation of AP [18–24]. Furthermore, in 2012 the Atlanta classification of AP was revisited and a new form of moderately severe AP was identified [14].…”

Section: Introductionmentioning

confidence: 99%

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The clinical value of adipokines in predicting the severity and outcome of acute pancreatitis

et al. 2016

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BackgroundRecent data shows that patients with severe acute pancreatic might benefit from early intensive therapy, enteral nutrition and timely transfer to specialized centers. The early prophylactic use of antibiotics in AP remains controversial. The role and need for new markers in stratification of acute pancreatitis is also uncertain. This study aims to evaluate the prognostic usefulness of adipokines in prediction of the severity and outcome of acute pancreatitis (AP).MethodsProspective study was conducted in four clinical centers. The diagnosis and severity assessment of AP was established according to the revised 2012 Atlanta classification. Adipokines, IL-6 and CRP levels were measured at admission and on 3rd day of hospital stay and compared with the control group. The predictive accuracy of each marker was measured by area under the receiver operating curve.ResultsForty healthy controls and 102 patients were enrolled in to the study. Twenty seven (26.5 %) patients had mild, 55 (53.9 %) - moderate and 20 (19.6 %) - severe AP. Only resistin (cut-off value 13.7 ng/ml) and IL-6 (cut-off value 473.4 pg/ml) were reliable early markers of SAP. IL-6 with cut-off value of 157.0 pg/ml was a predictor of necrosis. The peripancreatic necrosis volume of 112.5 ml was a marker of SAP and 433.0 ml cut-off value could be used to predict the need of interventions.ConclusionsThe prognostic value of adipokines in AP is limited. Only admission resistin levels could serve as an early predictor for SAP.The Lithuanian Regional Ethics Committee approved the study protocol (permission No. L-12-02/1/2/3/4) and all the patients and the control group provided written informed consent.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The clinical value of adipokines in predicting the severity and outcome of acute pancreatitis

et al. 2016

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“…A number of previous studies also suggested that leptin may be a predictor of severity of AP. 36 – 38 This study however has not shown a similar pattern (alone: P = 0.449; interaction with persistence of hyperglycemia: P = 0.094). 12 , 38 , 39 …”

Section: Discussioncontrasting

confidence: 55%

Leptin Is Associated With Persistence of Hyperglycemia in Acute Pancreatitis

Kennedy

Askelund

Premkumar³

et al. 2016

Medicine

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Adipokines have many homeostatic roles, including modulation of glucose metabolism, but their role in the pathophysiology of hyperglycemia associated with acute and critical illnesses in general, and acute pancreatitis (AP) in particular, is largely unknown. This study aimed to investigate the relationship between a panel of adipokines and hyperglycemia in the early course of AP, as well as the role of adipokines as predictors of AP severity.Adiponectin, leptin, omentin, resistin, and visfatin were measured on a daily basis in the first 72 hours after hospital admission. A first set of analyses was undertaken with admission glycemia stratified by severity, and a second set of analyses was undertaken based on persistence of early hyperglycemia. All of the analyses were adjusted for confounders.A total of 32 patients with AP were included in this study. None of the studied adipokines was significantly associated with glucose level on admission. Leptin was significantly (P = 0.003) increased in patients with persistent hyperglycemia. Adiponectin was significantly associated with the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in patients with persistent hyperglycemia (P = 0.015), visfatin with APACHE II score in patients with persistent hyperglycemia (P = 0.014), and omentin with APACHE II score in all of the patients regardless of the presence or absence of hyperglycemia (P = 0.021).Leptin is significantly associated with persistent hyperglycemia in the early course of AP. Omentin has a potential to become an accurate predictor of AP severity.

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“…In our study, serum ghrelin levels at admission were significantly lower in patients with AP than in healthy controls. This result is in agreement with the findings of Panek et al, [ 26 ] but contrasts with the results of Daniel et al, [ 13 ] who found higher serum ghrelin levels in patients with AP than in controls. This discrepancy may be due to differences in the timing of blood sample collection and AP etiology.…”

Section: Discussionsupporting

confidence: 89%

Serum ghrelin, but not obestatin, is a potential predictor of acute pancreatitis severity

Wang

Qin²,

Liang³

et al. 2017

Medicine

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The roles of ghrelin and obestatin in AP remain controversial.This study investigates the effects and the predictive value of serum ghrelin and obestatin levels in the early stage of AP.A total of 193 consecutive patients with AP and 24 healthy controls were included. Patients were divided into mild acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP) groups. Serum levels of ghrelin and obestatin were measured on the first, third, and fifth days of hospitalization. The predictive value of serum ghrelin and obestatin levels on the first day in AP was examined using receiver-operating characteristic (ROC) curves.On the first day of hospitalization, the mean serum ghrelin level was significantly lower in patients with AP than in controls (P < .01). The serum ghrelin concentration decreased with increasing AP severity and was lower in patients with SAP than in those with MAP and MSAP (P < .05). It increased gradually from the first to the fifth day after treatment. ROC curves demonstrated that the serum ghrelin level on the first day had some predictive value for AP severity (area under the ROC curve = 0.646), with an optimal cut-off value of 87.83 pg/mL. Logistic regression showed that the serum ghrelin level had independent predictive value for non-MAP (odds ratio = 10.94; 95% confidence interval, 5.08–23.55; P < .01). The serum obestatin level did not differ significantly between patients with AP and controls and had the limited predictive value for non-MAP (area under the ROC curve = 0.564). However, the serum obestatin concentration showed a “warning” effect regarding AP etiology; on the first day of treatment, it was significantly lower in patients with AP of hypertriglyceridemic etiology than in those with AP of biliary, alcohol-related, and other etiologies (P = .05, P = .031, and P = .029, respectively).Serum ghrelin and obestatin levels may be related to the progression of AP in the early stage. Only the serum ghrelin level is a potential predictor of AP severity in the early stage. Obestatin may be involved in the pathogenesis of AP caused by hypertriglyceridemia.

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Serum Leptin and Ghrelin Levels in Patients in the Early Stages of Acute Biliary Pancreatitis and Different Degrees of Severity

Abstract: The results of our study do not support the role of leptin as a marker of the severity of ABP. On the other hand, rising serum ghrelin levels during the course of ABP may be a marker of recovery and an indicator of the healing process.

Cited by 11 publications

References 20 publications

The clinical value of adipokines in predicting the severity and outcome of acute pancreatitis

The clinical value of adipokines in predicting the severity and outcome of acute pancreatitis

Leptin Is Associated With Persistence of Hyperglycemia in Acute Pancreatitis

Serum ghrelin, but not obestatin, is a potential predictor of acute pancreatitis severity

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