{"title":"基线血清雌二醇水平与中重度和重度急性胰腺炎患者急性肾损伤相关","authors":"Jia-Jia Pan, Wei-Li Liu, Guo-Tao Lu, Xing-Jie Ma, Qing-Bin Zheng, Guang-Fa Wei, Ge-Yan Tian, Li-Jun Meng","doi":"10.1155/2022/2623199","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sexual dimorphism with critical diseases has been documented. However, the role of serum sex hormones for the presence of acute kidney injury (AKI) in moderately or severe acute pancreatitis (MSAP and SAP) patients remains controversial. Here we set out to evaluate whether early (first 48 h) serum estradiol level is associated with AKI in patients with MSAP and SAP. <i>Patients and Methods</i>. We retrospectively collected data from patients with preliminary diagnosis of MSAP and SAP from the Affiliated Hospital of Yangzhou University between January 2014 and June 2018. Serum sex hormones were extracted for further assessment within first 48 h following admission. Logistic regression analysis and the receiving operating characteristic (ROC) curve were applied to evaluate the association and correlation between serum sex hormones and AKI.</p><p><strong>Results: </strong>Data from a total of 122 patients with MSAP or SAP were enrolled in this study. There were no differences in the incidence of AKI between males and females. However, comparing with patients without AKI, those with AKI saw higher estradiol level (<i>p</i> ≤ 0.01) and slight higher progesterone level (<i>p</i> = 0.014) but similar testosterone level (<i>p</i> = 0.668). Interestingly, during both the manual selection and the stepwise backward logistic regression analysis, serum estradiol level was independently associated with AKI in patients with MSAP and SAP (OR 4.699, CI 1.783-12.386, and <i>p</i> = 0.002). Additionally, area under the curve of ROC (AUCROC) showed that serum estradiol level was a proper predictor for AKI (area under the curve 0.875). Specifically, the serum estradiol level of 223.15 pg/mL demonstrated a 92.3% sensitive and a 79.3% specificity in predicting AKI of MSAP and SAP patients, respectively.</p><p><strong>Conclusions: </strong>High baseline serum estradiol level appears to be an independent risk factor for AKI in patients with MSAP and SAP. It also tends to be an appropriate indicator for AKI.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":"2623199"},"PeriodicalIF":2.0000,"publicationDate":"2022-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9252850/pdf/","citationCount":"1","resultStr":"{\"title\":\"Baseline Serum Estradiol Level Is Associated with Acute Kidney Injury in Patients with Moderately Severe and Severe Acute Pancreatitis.\",\"authors\":\"Jia-Jia Pan, Wei-Li Liu, Guo-Tao Lu, Xing-Jie Ma, Qing-Bin Zheng, Guang-Fa Wei, Ge-Yan Tian, Li-Jun Meng\",\"doi\":\"10.1155/2022/2623199\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Sexual dimorphism with critical diseases has been documented. However, the role of serum sex hormones for the presence of acute kidney injury (AKI) in moderately or severe acute pancreatitis (MSAP and SAP) patients remains controversial. Here we set out to evaluate whether early (first 48 h) serum estradiol level is associated with AKI in patients with MSAP and SAP. <i>Patients and Methods</i>. We retrospectively collected data from patients with preliminary diagnosis of MSAP and SAP from the Affiliated Hospital of Yangzhou University between January 2014 and June 2018. Serum sex hormones were extracted for further assessment within first 48 h following admission. Logistic regression analysis and the receiving operating characteristic (ROC) curve were applied to evaluate the association and correlation between serum sex hormones and AKI.</p><p><strong>Results: </strong>Data from a total of 122 patients with MSAP or SAP were enrolled in this study. There were no differences in the incidence of AKI between males and females. However, comparing with patients without AKI, those with AKI saw higher estradiol level (<i>p</i> ≤ 0.01) and slight higher progesterone level (<i>p</i> = 0.014) but similar testosterone level (<i>p</i> = 0.668). Interestingly, during both the manual selection and the stepwise backward logistic regression analysis, serum estradiol level was independently associated with AKI in patients with MSAP and SAP (OR 4.699, CI 1.783-12.386, and <i>p</i> = 0.002). Additionally, area under the curve of ROC (AUCROC) showed that serum estradiol level was a proper predictor for AKI (area under the curve 0.875). Specifically, the serum estradiol level of 223.15 pg/mL demonstrated a 92.3% sensitive and a 79.3% specificity in predicting AKI of MSAP and SAP patients, respectively.</p><p><strong>Conclusions: </strong>High baseline serum estradiol level appears to be an independent risk factor for AKI in patients with MSAP and SAP. It also tends to be an appropriate indicator for AKI.</p>\",\"PeriodicalId\":12597,\"journal\":{\"name\":\"Gastroenterology Research and Practice\",\"volume\":\" \",\"pages\":\"2623199\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2022-06-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9252850/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastroenterology Research and Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2022/2623199\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterology Research and Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2022/2623199","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 1
摘要
背景:两性异形与严重疾病有文献记载。然而，血清性激素在中度或重度急性胰腺炎(MSAP和SAP)患者急性肾损伤(AKI)中的作用仍然存在争议。在这里，我们开始评估早期(前48小时)血清雌二醇水平是否与MSAP和SAP患者的AKI相关。患者和方法。我们回顾性收集了2014年1月至2018年6月扬州大学附属医院初步诊断为MSAP和SAP的患者资料。入院后48小时内提取血清性激素进行进一步评估。采用Logistic回归分析和接受工作特征(ROC)曲线评价血清性激素与AKI的相关性。结果:本研究共纳入122例MSAP或SAP患者的数据。AKI的发生率在男性和女性之间没有差异。与无AKI患者相比，AKI患者雌二醇水平较高(p≤0.01)，孕酮水平略高(p = 0.014)，但睾酮水平相近(p = 0.668)。有趣的是，在手工选择和逐步反向logistic回归分析中，血清雌二醇水平与MSAP和SAP患者的AKI独立相关(OR 4.699, CI 1.783-12.386, p = 0.002)。此外，ROC曲线下面积(auroc)显示血清雌二醇水平是AKI的适当预测因子(曲线下面积0.875)。具体而言，223.15 pg/mL的血清雌二醇水平在预测MSAP和SAP患者AKI方面分别具有92.3%的敏感性和79.3%的特异性。结论:高基线血清雌二醇水平可能是MSAP和SAP患者AKI的独立危险因素，也可能是AKI的合适指标。
Baseline Serum Estradiol Level Is Associated with Acute Kidney Injury in Patients with Moderately Severe and Severe Acute Pancreatitis.
Background: Sexual dimorphism with critical diseases has been documented. However, the role of serum sex hormones for the presence of acute kidney injury (AKI) in moderately or severe acute pancreatitis (MSAP and SAP) patients remains controversial. Here we set out to evaluate whether early (first 48 h) serum estradiol level is associated with AKI in patients with MSAP and SAP. Patients and Methods. We retrospectively collected data from patients with preliminary diagnosis of MSAP and SAP from the Affiliated Hospital of Yangzhou University between January 2014 and June 2018. Serum sex hormones were extracted for further assessment within first 48 h following admission. Logistic regression analysis and the receiving operating characteristic (ROC) curve were applied to evaluate the association and correlation between serum sex hormones and AKI.
Results: Data from a total of 122 patients with MSAP or SAP were enrolled in this study. There were no differences in the incidence of AKI between males and females. However, comparing with patients without AKI, those with AKI saw higher estradiol level (p ≤ 0.01) and slight higher progesterone level (p = 0.014) but similar testosterone level (p = 0.668). Interestingly, during both the manual selection and the stepwise backward logistic regression analysis, serum estradiol level was independently associated with AKI in patients with MSAP and SAP (OR 4.699, CI 1.783-12.386, and p = 0.002). Additionally, area under the curve of ROC (AUCROC) showed that serum estradiol level was a proper predictor for AKI (area under the curve 0.875). Specifically, the serum estradiol level of 223.15 pg/mL demonstrated a 92.3% sensitive and a 79.3% specificity in predicting AKI of MSAP and SAP patients, respectively.
Conclusions: High baseline serum estradiol level appears to be an independent risk factor for AKI in patients with MSAP and SAP. It also tends to be an appropriate indicator for AKI.
期刊介绍：
Gastroenterology Research and Practice is a peer-reviewed, Open Access journal which publishes original research articles, review articles and clinical studies based on all areas of gastroenterology, hepatology, pancreas and biliary, and related cancers. The journal welcomes submissions on the physiology, pathophysiology, etiology, diagnosis and therapy of gastrointestinal diseases. The aim of the journal is to provide cutting edge research related to the field of gastroenterology, as well as digestive diseases and disorders.
Topics of interest include:
Management of pancreatic diseases
Third space endoscopy
Endoscopic resection
Therapeutic endoscopy
Therapeutic endosonography.
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