| Objective This study aimed to determine the features of lipid metabolic disorder and the degree of intestinal barrier damage and inflammatory response in patients with hyperlipidemic acute pancreatitis(HLAP),to further analyze whether the probiotics could relieve the inflammation by improving the intestinal barrier function,and to provide clinical data and research findings for the prevention and treatment of HLAP.Method A total of 99 serum samples were collected on the day of admission from patients with acute pancreatitis.According to the inclusion and exclusion criteria,57 patients with acute pancreatitis were included.Among them,27 patients had HLAP,and30 patients had non-hyperlipidemic acute pancreatitis(NHLAP).In the hyperlipidemic acute pancreatitis group,a one-month probiotic intervention was randomized,including10 patients in the probiotic intervention group and 17 patients in the conventional treatment group,and serum was collected after the treatment.The changes in the levels of the indicators of intestinal barrier functions were detected by using the Limulus amebocyte lysate or spectrophotometry,namely,diamine oxidase,D-lactate,and endotoxin.The levels of leptin and adiponectin secreted by adipocytes as well as the contents of inflammatory-related indicators were measured by enzyme linked immunosorbent assay(ELISA),including tumor necrosis factor-?(TNF-?),interleukin-1?(IL-1?),interleukin-6(IL-6)and interleukin-10(IL-10).The clinical data and indicator measurements of all patients were input into Epidata and analyzed by using the SPSS 22.0 software.The differences between the HLAP and NHLAP groupsin the levels of indicators related to lipid metabolism,intestinal barrier function,and inflammatory response were compared.Besides,the differences in the above indicators were further compared between HLAP patients receiving conventional treatment and those receiving probiotic treatment.Result As compared with the NHLAP group,the percentage of patients combined with diabetes increased significantly in the HLAP group(P=0.019).BMI of the HLAP patients was significantly higher than that of the NHLAP patients(P=0.007).The leptin level of the HLAP group increased considerably(P<0.001),while the adiponectin level decreased,but not significantly(P=0.754),indicating apparent lipid metabolic disorder in HLAP patients.Also,the intestinal barrier damage was more severe.As compared with the NHLAP group,the level of diamine oxidase in the HLAP group increased more significantly(P=0.031).The level of D-lactate only increased slightly(P=0.872),while that of the endotoxin was considerably higher than that of the NHLAP group(P=0.024).The inflammatory response was more intense in the HLAP patients,in which TNF-?,IL-1?,and IL-6 levels were much higher than those of the NHLAP group(P=0.049,0.022,0.01,respectively).The IL-10 level was only insignificantly higher in the NHLAP group than in the HLAP group(P=0.14).After treatment,the level of leptin,diamine oxidase,D-lactic acid and IL 6 was significantly reduced in probiotic intervention group,and the difference compared with before treatment was significant(P = 0.03,0.001,0.001,0.01,respectively);As compared with the conventional treatment group,the levels of diamine oxidase,D-lactate,and endotoxin decreased significantly in the probiotic treatment group.The differences in the levels of diamine oxidase and D-lactate between the groups were significant(P=0.03,0.04).Conclusion An imbalance in the secretion of leptin and adiponectin by adipocytes may be one of the reasons for lipid metabolic disorder in HLAP patients.Lipid metabolic disorder will further cause changes in gut microflora and intestinal barrier damage.Consequently,excessive release of the inflammatory mediators will occur as the immune response is triggered,which further aggravates HLAP.Probiotic regulatelipid metabolism and protecting the intestinal barrier function may alleviate the inflammatory response associated with HLAP,thereby promoting recovery from the disease. |
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