Predictive Value Of Combined Serum Resistin,Malondialdehyde And IL-6 Tests For The Severity Of Acute Pancreatitis

Acute pancreatitis(AP)is a common gastroenterological emergency.Patients may experience transient or persistent organ failure and progress to severe acute pancreatitis(SAP)with a mortality rate of 15%-35%,and early prediction of the severity of AP is of great value in its treatment and prognosis.Obese patients with AP have been found to be more likely to develop SAP and have a poor prognosis in clinical practice.The role of adipose tissue in the development of AP and the mechanisms involved are not yet fully understood.Domestic and international studies have found that visceral adipose tissue plays a central role in the development of AP and that adipose pancreas is associated with SAP;visceral adipose tissue,especially pancreatic adipose tissue,can contribute to the development of SAP through adipokines and lipid metabolism.The purpose of this study was to investigate the predictive value of the combined detection of adipokine resistin,malondialdehyde,the product of lipid peroxidation,and inflammatory factor IL-6 in patients with AP.One hundred and twenty patients with AP,90 males and 30 females,who were hospitalized in the Department of Gastroenterology of Hebei Provincial People’s Hospital from January 2022 to November 2022,were selected.The patients were divided into 3 groups:mild acute pancreatitis(MAP)group(66),moderate severe acute pancreatitis(MSAP)group(30),and severe acute pancreatitis(SAP)group(24).General information was collected from the patients,their height,weight,waist circumference and hip circumference were measured,waist-to-hip ratio and BMI were calculated,and modified Marshall score was performed on the included patients,together with SIRS score and APACHE Ⅱ score.Four ml of venous blood was drawn from patients within 48 to 72 hours of onset,and serum resistin,malondialdehyde and IL-6 levels were measured by ELISA,and CRP,PCT,TC and TG were collected from patients.The levels of serum resistin,malondialdehyde and IL-6 were compared between the three groups to assess the predictive value of the combination of serum resistin,malondialdehyde and IL-6 on the severity of AP,and to analyse the relationship between patients’ BMI,waist-to-hip ratio and blood lipid indexes with their SIRS status and the severity of AP.The results of the study showed that(1)the differences in serum resistin,malondialdehyde and IL-6 levels between the MAP,MSAP and SAP groups were statistically significant(462.87(251.20,680.92)ng/ml,854.25(654.39,1116.56)ng/ml,1167.60(762.01,2055.89)ng/ml,χ~2=45.97,,P<0.05;261.80(160.24,555.60)ng/ml,507.55(361.50,702.17)ng/ml,863.41(522.13,1096.78)ng/ml,x2=31.07,P<0.05;14.58(8.12,27.64)pg/ml,35.43(14.69,42.98)pg/ml,46.55(36.05,65.97)pg/ml,χ~2=43.42,P<0.05)).There was a significant difference in waist-hip ratio between the three groups(0.93(0.90,0.99),0.96(0.92,1.01),0.97(0.95,1.03),x2=10.61,P<0.05).(2)There was a significant linear correlation between resistin,malondialdehyde and IL-6(P<0.01).There were significant linear correlations between resistin and APACHE Ⅱ score,CRP,PCT and waist-to-hip ratio(P<0.01);malondialdehyde and APACHE Ⅱscore,PCT,waist-to-hip ratio and BMI(P<0.01);IL-6 and APACHE Ⅱscore,CRP,PCT and waist-to-hip ratio(P<0.01).(3)The area under the ROC curve for serum resistin,malondialdehyde and IL-6 to predict SAP(MSAP+SAP)was 0.850,0.774 and 0.817,respectively,with sensitivity and specificity of 77.80%and 78.80%;90.70%and 62.10%;72.20%and 83.30%,respectively.The area under the ROC curve for the combined assay of serum resistin,malondialdehyde and IL-6 to predict SAP(MSAP+SAP)was 0.890 with a sensitivity and specificity of 74.10%and 90.90%respectively.(4)Increased levels of serum resistin,malondialdehyde and IL-6 will increase the severity of AP,and all three are independent risk factors for SAP(MSAP+SAP)(OR=1.003,95%CI 1.001 to 1.005,P<0.05;OR=1.002,95%CI 1.000 to 1.004,P<0.05;OR=(1.062,95%CI 1.017 to 1.109,P<0.05).(5)The combined SIRS group had higher levels of serum resistin,malondialdehyde and IL-6 than the non-combined SIRS group,with statistically significant differences between the two groups(P<0.05).The findings suggest that serum resistin,malondialdehyde and IL-6 are significantly elevated in SAP patients,and that the combination of adipokine resistin,lipid peroxide malondialdehyde and inflammatory factor IL-6 has high efficacy and may be a new method to predict the severity of AP.