Serum paraoxonase (a high-density lipoprotein-associated lipophilic antioxidant) activity in clinical follow-up of patients with acute pancreatitis, with particular emphasis on oxidative stress parameters and lipid profile: a prospective pilot trial

Yuksekdag, Sema; Yüksel, Esra Pancar; Topcu, Ahmet; Karaagac, Neslihan; Uzun, Hafize; Kiziler, Ali Rıza; Ezbercı, Fikret; Unal, Ethem

doi:10.1080/19932820.2019.1595955

Cited by 5 publications

(3 citation statements)

References 27 publications

(57 reference statements)

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“…Previous studies show that patients with severe acute pancreatitis are often accompanied by hypocholesterolemia [12,50]. Regarding the lipid profile status in acute pancreatitis, a decrease in HDL level has been reported; an abnormal lipid profile may have a role in the pathogenesis of acute pancreatitis in which HDL-associated antioxidant defense is impaired [51]. In this study, it was shown that the decrease in HDL-C levels is a clinical indicator with possible predictive capacity, with a comparable diagnosis in the analysis of significant ROC curves (p < 0.004) and an AUC > 0.750 with a cut-off point of 28.5 mg/dL for MOF, which was maintained from admission to 48 h of hospital stay in the ED (Figure 1B,D).…”

Section: Discussionmentioning

confidence: 99%

Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department

Venegas-Tamayo,

Peña-Veites,

Hernández-González

et al. 2023

Life

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High-density lipoprotein cholesterol (HDL-C) is reported as a biomarker of systemic inflammation and multi-organ failure (MOF), which has been rarely investigated in acute pancreatitis (AP), a frequent condition in the emergency department (ED). The objective was to study the predictive capacity of the decrease in HDL-C to the progression of MOF in AP in the ED; analyzing 114 patients with AP for one year in a cross-sectional and prospective study, AP severity was obtained by the Atlanta classification, in relation to modified Marshall and Bedside Index for Severity in Acute Pancreatitis (BISAP) scores, and clinical and laboratory parameters in a 48 h hospital stay. The area under the receiver operating characteristic (ROC) curve was used to estimate the validity of the predictor and define optimal cut-off points. It was found that AP was classified as severe in 24.5%, mainly for biliary etiology (78.9%) and female sex (73.6%). As a biomarker, HDL-C decreased from 31.6 to 29.5 mg/dL in a 48 h stay (p < 0.001), correlating negatively with the increase in severity index > 2 and the modified Marshall (p < 0.032) and BISAP (p < 0.009) scores, finding an area under the ROC curve with a predictive capacity of 0.756 (95% CI, 0.614–0.898; p < 0.004) and a cut-off point of 28.5 mg/dL (sensitivity: 79%, specificity: 78%), demonstrating that the decrease in HDL-C levels serves as a useful indicator with a predictive capacity for MOF in mild to severe AP, during a 48 h hospital stay in the ED.

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Section: Discussionmentioning

confidence: 99%

Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department

Venegas-Tamayo,

Peña-Veites,

Hernández-González

et al. 2023

Life

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“…The impaired anti-inflammatory function might be linked to reduced HDL-C levels in AP leading to increased free fatty acids (FFAs), which produce an acidic microenvironment (Zhang et al, 2017). HDL-C also possesses an antioxidant ability, which is mediated by the paraoxonase-1 activity in AP (Yuksekdag et al, 2019). Notably, the presence of FFAs results from the breakdown of TG including chylomicrons and is associated with HTG AP.…”

Section: Discussionmentioning

confidence: 99%

Metabolites and lipoproteins may predict the severity of early Acute Pancreatitis in a South African cohort

Mazibuko,

Elebo,

Williams

et al. 2023

Preprint

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BackgroundAcute pancreatitis (AP) is a common clinical disease with varying severity. The Revised Atlanta Classification (RAC) categorises AP into mild, moderately severe, and severe (MAP, MSAP and SAP) respectively. Despite the availability of different scoring systems to triage patients, these are not always suitable for predicting the course and outcome of certain patients during admission. In this study, untargeted metabolomics was used to identify metabolic parameters that can potentially be used as prognostic markers for stratifying the risk profiles of patients for improved management and treatment.MethodsSerum isolated from blood samples collected from 30 AP patients (8 MAP, 14 MSAP, and 8 SAP) and 9 healthy control (HC) individuals was analysed using1H nuclear magnetic resonance (NMR) spectroscopy. Wilcoxon and Kruskal–Walli’s rank-sum tests were used to compare differences in numerical covariates. A liposcale test was used for lipoprotein characterization and the Spearman rank test was conducted for correlation of the data. P-values < 0.05 were considered significant.ResultsElevated levels of lactate, (rho = 0.67; p-value < 0.001, FDR = 0.001), 3-hydroxybutyrate (rho = 0.46; p-value < 0.003, FDR = 0.013), acetoacetate (rho = 0.63; p-value < 0.001, FDR < 0.001) and lipid alpha-CH2 (rho = 0.45; p-value = 0.004, FDR = 0.013) were associated with AP severity as was decreased levels of ascorbate (rho = 0.46; p-value < 0.003, FDR = 0.013), methanol (rho = 0.46; p-value < 0.003, FDR = 0.013), glutamine (rho = -0.55; p-value < 0.001, FDR = 0.002), ethanol (rho = 0.64; p-value < 0.001, FDR< 0.001), protein-NH (rho= -0.75; p-value < 0.001, FDR<0.001) among others. HDL-C decreased while IDL-C and VLDL-C increased across all the AP metabolic phenotypes compared to the HC.ConclusionDysregulated metabolites and lipids can potentially add to the understanding of the pathophysiological conditions of AP and can aid in the early prognosis and stratification of patients for specialist care.

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“…Tvarijonaviciute et al ( 53 ) suggested that PON-1 activity is positively correlated with CRP and triglyceride levels and could be considered as a marker to assess AP severity. Yuksekdag et al ( 54 ) demonstrated that the low levels of PON-1, HDL-C, SOD and TAC identified in the early stages of AP started to increase after treatment with analgesics, antibiotics and enteral/parenteral nutrition, as well as insulin dose adjustment for diabetic patients and personal medication for arterial hypertension. Furthermore, the initially elevated MDA concentrations decreased, thus suggesting that PON-1, SOD and TAC might represent potential markers to evaluate the clinical course of the disease.…”

Section: Antioxidants and Oxidative Stressmentioning

confidence: 99%

Role of antioxidants and oxidative stress in the evolution of acute pancreatitis (Review)

et al. 2022

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Acute pancreatitis (AP) is a severe disease with a high prevalence and 3 to 15% mortality worldwide, which can represent an important challenge for the physician. Oxidative stress and antioxidants are involved in AP progression. The mechanisms responsible for the onset and progression of AP are still poorly understood. Previous studies have highlighted the important contribution of antioxidants and oxidative stress in AP. The existence of a relationship between oxidative stress and antioxidants in AP is unquestionable, although a more accurate understanding of the mechanistic pathways involved is required to create a solid basis for potential prevention or treatment strategies. Further investigation is needed to clarify the role of antioxidant status and the severity of AP and to determine the association between oxidative stress and pancreatic enzyme activities. Antioxidant therapy may represent an interesting option for the management of patients with AP, although additional information about the effectiveness of this potential treatment is required. Contents 1. Introduction 2. Methods 3. Antioxidants and oxidative stress 4. Conclusions

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Serum paraoxonase (a high-density lipoprotein-associated lipophilic antioxidant) activity in clinical follow-up of patients with acute pancreatitis, with particular emphasis on oxidative stress parameters and lipid profile: a prospective pilot trial

Abstract: (2019) Serum paraoxonase (a high-density lipoprotein-associated lipophilic antioxidant) activity in clinical follow-up of patients with acute pancreatitis, with particular emphasis on oxidative stress parameters and lipid profile: a prospective pilot trial,

Cited by 5 publications

References 27 publications

Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department

Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department

Metabolites and lipoproteins may predict the severity of early Acute Pancreatitis in a South African cohort

Role of antioxidants and oxidative stress in the evolution of acute pancreatitis (Review)

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