血清脂联素、网膜素及内脂素水平与急性胰腺炎严重程度的相关性分析

许新; 陈章兴

doi:10.12449/JCH240920

血清脂联素、网膜素及内脂素水平与急性胰腺炎严重程度的相关性分析

DOI: 10.12449/JCH240920

许新^, ,,
陈章兴

厦门大学附属成功医院消化内科，福建厦门 361000

基金项目:

厦门市卫生指导性项目 (3502Z20199063)

伦理学声明：本研究方案于2024年3月30日经由厦门大学附属成功医院伦理委员会审批，批号：73JYY2024137744。

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：许新负责课题设计，收集数据，资料分析，撰写论文及修改论文；陈章兴负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
许新， xuxing19891031@126.com （ORCID： 0000-0002-2966-9459）

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出版历程
- 收稿日期: 2024-01-19
- 录用日期: 2024-04-07
- 出版日期: 2024-09-25

Correlation of the serum levels of adiponectin， omentin， and visfatin with the severity of acute pancreatitis

Xin XU^{,
,},
Zhangxing CHEN

Department of Gastroenterology，Chenggong Hospital Affiliated to Xiamen University，Xiamen，Fujian 361000，China

Research funding:

Xiamen City Health Guidance Project (3502Z20199063)

More Information

Corresponding author: XU Xin， xuxing19891031@126.com （ORCID： 0000-0002-2966-9459）

摘要

摘要: 目的探讨血清脂联素、网膜素及内脂素水平与急性胰腺炎（AP）严重程度的相关性。方法收集2022年3月—2023年10月厦门大学附属成功医院收治的70例AP患者和35例对照组健康者的血液标本，采用酶联免疫吸附试验检测各组入院24 h内血清脂联素、网膜素及内脂素水平。计量资料组间比较采用方差分析，进一步两两比较采用LSD-t检验；计数资料组间比较采用χ²检验。各指标相关性用Pearson相关性分析，采用受试者工作特征曲线评估3项指标对重症急性胰腺炎（SAP）预测价值。结果 AP组的血清网膜素及内脂素水平明显高于对照组（t值分别为5.51、9.41，P值均<0.01），随着病情的加重，内脂素水平逐渐升高（F=43.32，P<0.01），而网膜素随着病情的加重变化不明显（F=0.47，P>0.05）。AP组的脂联素水平低于对照组（t=-14.47，P<0.01），且随着病情的加重而逐渐下降（F=35.61，P<0.01）。血清内脂素水平与急性生理与慢性健康评分（APACHE-Ⅱ评分）正相关（r=0.547，P<0.01），脂联素水平与之负相关（r=-0.520，P<0.01），而网膜素与APACHE-Ⅱ评分关系不明显（r=0.007，P>0.05）。3项指标预测SAP的受试者工作特征曲线下面积（AUC）分别为0.893、0.570及0.829，将AUC>0.7的脂联素及内脂素两组联合检测时SAP的AUC为0.953，敏感度0.900，特异度0.933。结论血清脂联素及内脂素水平与AP的严重程度密切相关，对预测SAP具有重要的临床意义，两者联合检测具有更高的价值，但网膜素水平与AP的严重程度是否相关尚需进一步研究。
- 胰腺炎，急性坏死性 /
- 脂联素 /
- 烟酰胺磷酸核糖基转移酶
Abstract: Objective To investigate the correlation of the serum levels of adiponectin， omentin， and visfatin with the severity of acute pancreatitis （AP）. Methods Blood samples were collected from 35 healthy individuals in the control group and 70 patients with AP who were admitted to Chenggong Hospital Affiliated to Xiamen University from March 2022 to October 2023， and enzyme-linked immunosorbent assay was used to measure the serum levels of adiponectin， omentin， and visfatin in each group within 24 hours after admission. The analysis of variance was used for comparison of continuous between groups， and the LSD-t test was used for further comparison between two groups； the chi-square test was used for comparison of categorical data between groups. The Pearson correlation analysis was used to investigate the correlation between indicators， and the receiver operating characteristic （ROC） curve was used to investigate the value of the three indicators in predicting severe acute pancreatitis （SAP）. Results Compared with the control group， the AP group had significantly higher serum levels of omentin and visfatin （t=5.51 and 9.41， both P<0.01）， and the level of visfatin gradually increased with the aggravation of the disease （F=43.32， P<0.01）， while there was no significant change in omentin with the aggravation of the disease （F=0.47， P>0.05）. The AP group had a significantly lower level of adiponectin than the control group （t=-14.47， P <0.01）， and the level of adiponectin gradually decreased with the aggravation of the disease （F=35.61， P<0.01）. The serum level of visfatin was positively correlated with Acute Physiology and Chronic Health Evaluation II （APACHE-II） score （r=0.547， P<0.01）， and the level of adiponectin was negatively correlated with APACHE-II score （r=-0.520， P<0.01）， while there was no significant correlation between omentin APACHE-II score （r=0.007， P>0.05）. The three indicators had an area under the ROC curve （AUC） of 0.893， 0.570， and 0.829， respectively， in predicting SAP， and combined measurement of adiponectin and visfatin with an AUC of >0.7 showed an AUC of 0.953 in predicting SAP， with a sensitivity of 0.900 and a specificity of 0.933. Conclusion The serum levels of adiponectin and visfatin are correlated with the severity of AP and have an important clinical significance in predicting SAP， and combined measurement of the two indicators has a higher value， while further studies are needed to investigate the correlation of omentin level with the severity of AP.
- Pancreatitis， Acute Necrotizing /
- Adiponectin /
- Nicotinamide Phosphoribosyltransferase

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图 1 血清脂联素水平与APACHE-Ⅱ评分的相关性

Figure 1. Correlation between serum adiponectin level and APACHE-Ⅱscore.

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图 2 血清网膜素水平与APACHE-Ⅱ评分的相关性

Figure 2. Correlation between serum omentin level and APACHE-Ⅱscore.

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图 3 血清内脂素水平与APACHE-Ⅱ评分的相关性

Figure 3. Correlation between serum visfatin level and APACHE-Ⅱ score.

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图 4 血清脂联素、网膜素及内脂素水平预测SAP的ROC曲线

Figure 4. The ROC curve of serum adiponectin， omentin and visfatin levels for predicting SAP

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表 1 两组患者血清脂联素、网膜素及内脂素水平比较

Table 1. Comparison of serum adiponectin， omentin and visfatin levels between two groups

组别	例数	脂联素（μg/mL）	网膜素（ng/mL）	内脂素（μg/mL）
AP组	70	9.19±2.67	31.12±8.27	8.60±1.95
对照组	35	18.56±3.90	23.05±3.64	2.31±0.54
t值		-14.47	5.51	9.41
P值		<0.001	<0.001	<0.001

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表 2 AP组不同严重程度患者血清脂联素、网膜素及内脂素水平比较

Table 2. Comparison of serum adiponectin， omentin and visfatin levels in AP patients with different severity

组别	例数	脂联素（μg/mL）	网膜素（ng/mL）	内脂素（μg/mL）
MAP组	35	10.34±1.88	31.55±7.05	7.35±1.39
MSAP组	25	8.97±2.57^1）	30.83±9.40	9.50±1.29^1）
SAP组	10	5.72±2.19^1）2）	30.38±9.95	10.75±1.96^1）2）
F值		35.61	0.47	43.32
P值		<0.001	0.82	<0.001
注：与MAP组比较，1）P<0.05；与MASP组比较，2）P<0.05。

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表 3 血清脂联素、网膜素及内脂素预测SAP效能分析

Table 3. Analysis of the predictive efficacy of serum adiponectin， omentin and visfatin in SAP

指标	最佳临界值	AUC	P值	敏感度	特异度	95%CI
脂联素	6.85 μg/mL	0.893	<0.001	0.800	0.917	0.790～0.997
网膜素	33.2 ng/mL	0.570	0.481	0.800	0.467	0.37～0.770
内脂素	8.70 μg/mL	0.829	0.001	0.800	0.633	0.704～0.954
脂联素+内脂素	-	0.953	<0.001	0.900	0.933	0.903～1.000

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参考文献(27)

[1]	CHEN SC, ZHU JF, SUN LQ, et al. LincRNA-EPS alleviates severe acute pancreatitis by suppressing HMGB1-triggered inflammation in pancreatic macrophages[J]. Immunology, 2021, 163( 2): 201- 219. DOI: 10.1111/imm.13313.
[2]	BARRETO SG, HABTEZION A, GUKOVSKAYA A, et al. Critical thresholds: Key to unlocking the door to the prevention and specific treatments for acute pancreatitis[J]. Gut, 2021, 70( 1): 194- 203. DOI: 10.1136/gutjnl-2020-322163.
[3]	HU XY, YANG ZY, ZHAO CJ, et al. Research progress in acute pancreatitis scoring systems in predicting the severity of disease[J/OL]. Chin J Hepatic Surg(Electronic Edition), 2024, 13( 2): 239- 243. DOI: 10.3877/cma.j.issn.2095-3232.2024.02.021. 胡欣芫, 杨智義, 赵成俊, 等. 急性胰腺炎评分系统预测病情严重程度的研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13( 2): 239- 243. DOI: 10.3877/cma.j.issn.2095-3232.2024.02.021.
[4]	HARSHIT KUMAR A, SINGH GRIWAN M. A comparison of APACHE II, BISAP, Ranson’s score and modified CTSI in predicting the severity of acute pancreatitis based on the 2012 revised Atlanta Classification[J]. Gastroenterol Rep, 2018, 6( 2): 127- 131. DOI: 10.1093/gastro/gox029.
[5]	DI MY, LIU H, YANG ZY, et al. Prediction models of mortality in acute pancreatitis in adults: A systematic review[J]. Ann Intern Med, 2016, 165( 7): 482- 490. DOI: 10.7326/M16-0650.
[6]	SILVA-VAZ P, ABRANTES AM, CASTELO-BRANCO M, et al. Multifactorial scores and biomarkers of prognosis of acute pancreatitis: Applications to research and practice[J]. Int J Mol Sci, 2020, 21( 1): 338. DOI: 10.3390/ijms21010338.
[7]	KUMARI R, KUMAR S, KANT R. An update on metabolic syndrome: Metabolic risk markers and adipokines in the development of metabolic syndrome[J]. Diabetes Metab Syndr, 2019, 13( 4): 2409- 2417. DOI: 10.1016/j.dsx.2019.06.005.
[8]	ZHAO CL, SHANG DF, ZHOU C, et al. Mechanism of lipid metabolism mediated by hepatokines and adipokines in nonalcoholic fatty liver disease[J]. J Clin Hepatol, 2023, 39( 1): 168- 174. DOI: 10.3969/j.issn.1001-5256.2023.01.026. 赵晨露, 尚东方, 周铖, 等. 肝因子和脂肪因子介导的脂代谢在非酒精性脂肪性肝病中的作用机制[J]. 临床肝胆病杂志, 2023, 39( 1): 168- 174. DOI: 10.3969/j.issn.1001-5256.2023.01.026.
[9]	YIN JY, WANG Q. Progress on adipokines in non-alcoholic fatty liver disease[J/CD]. Chin J Liver Dis(Electronic Version), 2023, 15( 1): 1- 5. DOI: 10.3969/j.issn.1674-7380.2023.01.001. 尹静亚, 王琦. 脂肪因子在非酒精性脂肪性肝病中研究进展[J/CD]. 中国肝脏病杂志(电子版), 2023, 15( 1): 1- 5. DOI: 10.3969/j.issn.1674-7380.2023.01.001.
[10]	SCHÄFFLER A, LANDFRIED K, VÖLK M, et al. Potential of adipocytokines in predicting peripancreatic necrosis and severity in acute pancreatitis: Pilot study[J]. J Gastroenterol Hepatol, 2007, 22( 3): 326- 334. DOI: 10.1111/j.1440-1746.2006.04364.x.
[11]	SHARMA A, MUDDANA V, LAMB J, et al. Low serum adiponectin levels are associated with systemic organ failure in acute pancreatitis[J]. Pancreas, 2009, 38( 8): 907- 912. DOI: 10.1097/MPA.0b013e3181b65bbe.
[12]	KARPAVICIUS A, DAMBRAUSKAS Z, GRADAUSKAS A, et al. The clinical value of adipokines in predicting the severity and outcome of acute pancreatitis[J]. BMC Gastroenterol, 2016, 16( 1): 99. DOI: 10.1186/s12876-016-0514-4.
[13]	Group of Pancreatic Surgery, Surgery Society of Chinese Medical Association. Guidelines for diagnosis and treatment of acute pancreatitis in China(2021)[J]. Chin J Surg, 2021, 59( 7): 578- 587. DOI: 10.3760/cma.j.cn112139-20210416-00172. 中华医学会外科学分会胰腺外科学组. 中国急性胰腺炎诊治指南(2021)[J]. 中华外科杂志, 2021, 59( 7): 578- 587. DOI: 10.3760/cma.j.cn112139-20210416-00172.
[14]	LI CR, LI X, LIU LX. Research progress of adipokine and acute pancreatitis[J]. Adv Clin Med, 2023, 13( 7): 11609- 11614. DOI: 10.12677/acm.2023.1371624. 李晨瑞, 李笑, 刘林勋. 脂肪因子与急性胰腺炎的相关研究进展[J]. 临床医学进展, 2023, 13( 7): 11609- 11614. DOI: 10.12677/acm.2023.1371624.
[15]	YAVUZ N, UNAL E, MEMISOGLU K, et al. Plasma leptin levels in rats with pancreatitis[J]. Tohoku J Exp Med, 2004, 204( 4): 243- 248. DOI: 10.1620/tjem.204.243.
[16]	SCHERER PE, WILLIAMS S, FOGLIANO M, et al. A novel serum protein similar to C1q, produced exclusively in adipocytes[J]. J Biol Chem, 1995, 270( 45): 26746- 26749. DOI: 10.1074/jbc.270.45.26746.
[17]	KARPAVICIUS A, DAMBRAUSKAS Z, SILEIKIS A, et al. Value of adipokines in predicting the severity of acute pancreatitis: Comprehensive review[J]. World J Gastroenterol, 2012, 18( 45): 6620- 6627. DOI: 10.3748/wjg.v18.i45.6620.
[18]	WATANABE T, WATANABE-KOMINATO K, TAKAHASHI Y, et al. Adipose tissue-derived omentin-1 function and regulation[J]. Compr Physiol, 2017, 7( 3): 765- 781. DOI: 10.1002/cphy.c160043.
[19]	RAO SS, HU Y, XIE PL, et al. Omentin-1 prevents inflammation-induced osteoporosis by downregulating the pro-inflammatory cytokines[J]. Bone Res, 2018, 6: 9. DOI: 10.1038/s41413-018-0012-0.
[20]	LIU HP, WU JF, WANG HY, et al. Association of serum omentin-1 concentrations with the presence and severity of preeclampsia[J]. Ann Clin Biochem, 2015, 52( 2): 245- 250. DOI: 10.1177/0004563214541247.
[21]	ALI S, ALAM R, AHSAN H, et al. Role of adipokines(omentin and visfatin) in coronary artery disease[J]. Nutr Metab Cardiovasc Dis, 2023, 33( 3): 483- 493. DOI: 10.1016/j.numecd.2022.11.023.
[22]	SIT M, AKTAS G, YILMAZ EE, et al. Effects of the inflammatory response on serum omentin levels in early acute and chronic pancreatitis[J]. Clin Ter, 2014, 165( 2): e148- e152. DOI: 10.7471/CT.2014.1699.
[23]	MOSCHEN AR, KASER A, ENRICH B, et al. Visfatin, an adipocytokine with proinflammatory and immunomodulating properties[J]. J Immunol, 2007, 178( 3): 1748- 1758. DOI: 10.4049/jimmunol.178.3.1748.
[24]	SAWICKA K, MICHALSKA-JAKUBUS M, POTEMBSKA E, et al. Visfatin and chemerin levels correspond with inflammation and might reflect the bridge between metabolism, inflammation and fibrosis in patients with systemic sclerosis[J]. Postepy Dermatol Alergol, 2019, 36( 5): 551- 565. DOI: 10.5114/ada.2018.79104.
[25]	LU Y, TAO DX, HE ML. Expression of serum adipocytokines, lactones and IL-33 in patients with inflammatory bowel disease and their correlation with intestinal flora[J]. Mod Dig Interv, 2021, 26( 1): 85- 90. DOI: 10.3969/j.issn.1672-2159.2021.01.018. 陆游, 陶丁霞, 和明丽. 炎症性肠病患者血清脂肪细胞因子、内酯素、IL-33表达及与肠道菌群的相关性[J]. 现代消化及介入诊疗, 2021, 26( 1): 85- 90. DOI: 10.3969/j.issn.1672-2159.2021.01.018.
[26]	SCHÄFFLER A, HAMER OW, DICKOPF J, et al. Admission visfatin levels predict pancreatic and peripancreatic necrosis in acute pancreatitis and correlate with clinical severity[J]. Am J Gastroenterol, 2011, 106( 5): 957- 967. DOI: 10.1038/ajg.2010.503.
[27]	MEI PF, HUANG MF, KONG H, et al. Study on the correlation between serum visfatin changes and illness in patients with acute pancreatitis[J]. Chin J Pancreatol, 2015, 15( 1): 44- 45. DOI: 10.3760/cma.j.issn.1674-1935.2015.01.011. 梅鹏飞, 黄梅芳, 孔浩, 等. 急性胰腺炎患者血清内脂素变化与病情相关性研究[J]. 中华胰腺病杂志, 2015, 15( 1): 44- 45. DOI: 10.3760/cma.j.issn.1674-1935.2015.01.011.