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Early Prediction of Persistent Organ Failure by Serum Angiopoietin-2 in Patients with Acute Pancreatitis

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Abstract

Background

Biomarkers for the early prediction of the severity of acute pancreatitis (AP) are urgently needed for clinical management of the disease. Angiopoietin-2 (Ang-2), one of the autocrine peptides that reduce endothelial permeability, has been found to be associated with various diseases, including inflammatory disorders.

Aims

This study aimed to determine whether serum Ang-2 could serve as a noninvasive biomarker for the early prediction of persistent organ failure (POF) in acute pancreatitis.

Methods

A total of 120 AP patients were prospectively enrolled at Jinling Hospital. Serum samples were collected on admission. Clinical and laboratory data were recorded. Ang-2 levels were measured by enzyme-linked immunosorbent assay.

Results

A total of 37 patients developed POF and were classified as having severe AP (SAP). Ang-2 was significantly higher on admission in patients who developed POF than in those who did not (p < 0.001 for all). Furthermore, receiver operating characteristic (ROC) curve analysis revealed that Ang-2 could distinguish patients who developed POF from mild AP (MAP, area under ROC curve [AUC] = 0.88, 95 % CI 0.78–0.94) and moderately severe AP patients (MSAP, AUC = 0.74, 95 % CI 0.63–0.83). In addition, multivariate logistic regression showed that increased Ang-2 was an independent predictor of developing POF between subgroups with MSAP and SAP (OR 7.2, 95 % CI 2.7–19.4) and among all AP patients (OR 12.1, 95 % CI 4.8–30.3).

Conclusions

Elevated serum Ang-2 levels on admission may be a promising biomarker for the prediction of POF in AP.

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Acknowledgments

We thank Chunni Zhang and Cheng Wang for the serum sample collection. This research was supported by the National Natural Science Foundation of China (Grant No. 81270453).

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Jinling Hospital, Southern Medical University, Nanjing, 210002, China

    Yu-Ping Zhang, Chang Liu, Yuan-Ning Ye, Lin Wu & Fang-Yu Wang

  2. Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing University, Nanjing, 210002, China

    Lei Ye & Na Yu

  3. Department of Gastroenterology and Hepatology, Jinling Hospital, Clinical School of Nanjing, Second Military Medical University, Nanjing, 210002, China

    Wen-Rong Sun

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  1. Yu-Ping Zhang
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  2. Chang Liu
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  3. Lei Ye
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  4. Na Yu
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  5. Yuan-Ning Ye
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  6. Wen-Rong Sun
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  7. Lin Wu
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  8. Fang-Yu Wang
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Correspondence to Fang-Yu Wang.

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Zhang, YP., Liu, C., Ye, L. et al. Early Prediction of Persistent Organ Failure by Serum Angiopoietin-2 in Patients with Acute Pancreatitis. Dig Dis Sci 61, 3584–3591 (2016). https://doi.org/10.1007/s10620-016-4323-y

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  • DOI: https://doi.org/10.1007/s10620-016-4323-y

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