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

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

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χ^(2)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。

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 enzymelinked 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.