Correlation of plasma lipocalin-2 with inflammation and predictive value of lipocalin-2 for detecting acute kidney injury in acute pancreatitis_West China Medical Journal

Authors：

ZHOU Haolan ^1,2 , FU Ying ² ,  HUANG Yuanqing ²

1. Department of Gastrointestinal Surgery, Bazhong Municipal Hospital of Traditional Chinese Medicine, Bazhong, Sichuan 636000, P. R. China;
2. Intensive Care Unit, Bazhong Municipal Hospital of Traditional Chinese Medicine, Bazhong, Sichuan 636000, P. R. China;

Corresponding author：

HUANG Yuanqing, Email: 137400616@qq.com

Keywords：

Lipocalin-2; Acute pancreatitis; Acute kidney injury

DOI：

10.7507/1002-0179.201910043

Video：

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Objective To explore the correlation of serum lipocalin-2 (LCN2) with inflammation and the predictive value of LCN2 for detecting acute kidney injury (AKI) in acute pancreatitis (AP).Methods Nighty-one patients with AP, who were admitted to Bazhong Municipal Hospital of Traditional Chinese Medicine between June 2016 and June 2018, were enrolled in the present study. Clinical paramaters were analyzed between patients with AKI (n=29) and patients without AKI (n=62). The correlation of serum LCN2 with inflammation was assessed with Pearson’s correlation analysis. The area under the receiver operating characteristic curve (ROC AUC) for serum LCN2 predicting AKI in AP patients was assessed.Results Compared with the patients without AKI, the patients with AKI showed increased serum levels of C-reactive protein [(64.8±10.5) vs. (148.3±21.6) mg/L], procalcitonin [(3.5±2.3) vs. (4.8±3.9) μg/L], urea nitrogen [(5.5±2.1) vs. (6.6±2.8) mmol/L], creatinine [(80.3±28.1) vs. (107.3±30.8) μmol/L], interleukin-6 [(10.1±3.7) vs. (16.2±4.6) pg/mL], and LCN2 [(155.0±37.6) vs. (394.8±53.1) mg/mL], as well as decreased level of calcium [(2.6±1.3) vs. (2.0±1.0) mmol/L], the differences were all statistically significant (P<0.05). The serum level of LCN2 was correlated with C-reactive protein (r=0.694, P<0.05), interleukin-6 (r=0.762, P<0.05), and procalcitonin (r=0.555, P<0.05) in patients with AP. The ROC AUC of LCN2 for predicting AKI was 0.844 (P<0.05) , with a sensitivity of 81.3% and a specificity of 81.4% when the cut-off value was 210.2 ng/mL.Conclusions Serum LCN2 concentration is elevated in patients with AKI. In patients with AP, serum LCN2 level is positively correlated with C-reactive protein, interleukin-6, and procalcitonin. It can be regarded as a reliable indicator for predicting AKI.

Citation： ZHOU Haolan, FU Ying, HUANG Yuanqing. Correlation of plasma lipocalin-2 with inflammation and predictive value of lipocalin-2 for detecting acute kidney injury in acute pancreatitis. West China Medical Journal, 2020, 35(11): 1350-1356. doi: 10.7507/1002-0179.201910043 Copy

1.	Ojalvo D, Mazi EE, Kara M, et al. Is serum neutrophil gelatinase-associated lipocalin a useful marker in acute pancreatitis?. Eur J Intern Med, 2019, 67: e16-e17.
2.	Escobar-Arellano R, Guraieb-Barragán E, Mansanares-Hernández A, et al. Sensitivity, specificity and reliability of the POP score vs. APACHE II score as predictors of severe acute biliary pancreatitis. Cir Cir, 2019, 87(4): 402-409.
3.	Pozzoli S, Simonini M, Manunta P. Predicting acute kidney injury: current status and future challenges. J Nephrol, 2018, 31(2): 209-223.
4.	Chakraborty S, Kaur S, Muddana V, et al. Elevated serum neutrophil gelatinase-associated lipocalin is an early predictor of severity and outcome in acute pancreatitis. Am J Gastroenterol, 2010, 105(9): 2050-2059.
5.	Choudhary A, Basu S, Dey SK, et al. Association and prognostic value of serum Cystatin C, IL-18 and uric acid in urological patients with acute kidney injury. Clin Chim Acta, 2018, 482: 144-148.
6.	Fazel M, Sarveazad A, Mohamed Ali K, et al. Accuracy of urine kidney injury molecule-1 in predicting acute kidney injury in children; a systematic review and meta-analysis. Arch Acad Emerg Med, 2020, 8(1): e44.
7.	Hansson M, Gustafsson R, Jacquet C, et al. Cystatin C and α-1-microglobulin predict severe acute kidney injury in patients with hemorrhagic fever with renal syndrome. Pathogens (Basel, Switzerland), 2020, 9(8): 666.
8.	Cappuccilli M, Capelli I, Comai G, et al. Neutrophil gelatinase-associated lipocalin as a biomarker of allograft function after renal transplantation: evaluation of the current status and future insights. Artif Organs, 2018, 42(1): 8-14.
9.	Zhou F, Luo Q, Wang L, et al. Diagnostic value of neutrophil gelatinase-associated lipocalin for early diagnosis of cardiac surgery-associated acute kidney injury: a meta-analysis. Eur J Cardiothorac Surg, 2016, 49(3): 746-755.
10.	Cuartero M, Betbesé AJ, Núñez K, et al. Does whole-blood neutrophil gelatinase-associated lipocalin stratify acute kidney injury in critically ill patients?. Dis Markers, 2019, 2019: 8480925.
11.	Jonsson N, Gille-Johnson P, Martling CR, et al. Performance of plasma measurement of neutrophil gelatinase-associated lipocalin as a biomarker of bacterial infections in the intensive care unit. J Crit Care, 2019, 53: 264-270.
12.	中华医学会外科学分会胰腺外科学组. 急性胰腺炎诊治指南(2014 版). 中华消化外科杂志, 2015, 14(1): 1-5.
13.	郭锦洲. 改善全球肾脏病预后组织(KDIGO)临床实践指南: 急性肾损伤. 肾脏病与透析肾移植杂志, 2013, 22(1): 57-60.
14.	Portelli M, Jones CD. Severe acute pancreatitis: pathogenesis, diagnosis and surgical management. Hepatobiliary Pancreat Dis Int, 2017, 16(2): 155-159.
15.	Park HS, In SG, Yoon HJ, et al. Predictive values of neutrophil-lymphocyte ratio as an early indicator for severe acute pancreatitis in the emergency department patients. J Lab Physicians, 2019, 11(3): 259-264.
16.	Farkas N, Hanák L, Mikó A, et al. A multicenter, international cohort analysis of 1435 cases to support clinical trial design in acute pancreatitis. Front Physiol, 2019, 10: 1092.
17.	Kolber W, Dumnicka P, Maraj M, et al. Does the automatic measurement of interleukin 6 allow for prediction of complications during the first 48 h of acute pancreatitis?. Int J Mol Sci, 2018, 19(6): 1820.
18.	Bukosza EN, Kaucsár T, Godó M, et al. Glomerular collagen deposition and lipocalin-2 expression are early signs of renal injury in prediabetic obese rats. Int J Mol Sci, 2019, 20(17): 4266.
19.	Al-Naimi MS, Rasheed H, Hussien NR, et al. Nephrotoxicity: role and significance of renal biomarkers in the early detection of acute renal injury. J Adv Pharm Technol Res, 2019, 10(3): 95-99.
20.	Forster CS, Devarajan P. Neutrophil gelatinase-associated lipocalin: utility in urologic conditions. Pediatr Nephrol, 2017, 32(3): 377-381.

1. Ojalvo D, Mazi EE, Kara M, et al. Is serum neutrophil gelatinase-associated lipocalin a useful marker in acute pancreatitis?. Eur J Intern Med, 2019, 67: e16-e17.
2. Escobar-Arellano R, Guraieb-Barragán E, Mansanares-Hernández A, et al. Sensitivity, specificity and reliability of the POP score vs. APACHE II score as predictors of severe acute biliary pancreatitis. Cir Cir, 2019, 87(4): 402-409.
3. Pozzoli S, Simonini M, Manunta P. Predicting acute kidney injury: current status and future challenges. J Nephrol, 2018, 31(2): 209-223.
4. Chakraborty S, Kaur S, Muddana V, et al. Elevated serum neutrophil gelatinase-associated lipocalin is an early predictor of severity and outcome in acute pancreatitis. Am J Gastroenterol, 2010, 105(9): 2050-2059.
5. Choudhary A, Basu S, Dey SK, et al. Association and prognostic value of serum Cystatin C, IL-18 and uric acid in urological patients with acute kidney injury. Clin Chim Acta, 2018, 482: 144-148.
6. Fazel M, Sarveazad A, Mohamed Ali K, et al. Accuracy of urine kidney injury molecule-1 in predicting acute kidney injury in children; a systematic review and meta-analysis. Arch Acad Emerg Med, 2020, 8(1): e44.
7. Hansson M, Gustafsson R, Jacquet C, et al. Cystatin C and α-1-microglobulin predict severe acute kidney injury in patients with hemorrhagic fever with renal syndrome. Pathogens (Basel, Switzerland), 2020, 9(8): 666.
8. Cappuccilli M, Capelli I, Comai G, et al. Neutrophil gelatinase-associated lipocalin as a biomarker of allograft function after renal transplantation: evaluation of the current status and future insights. Artif Organs, 2018, 42(1): 8-14.
9. Zhou F, Luo Q, Wang L, et al. Diagnostic value of neutrophil gelatinase-associated lipocalin for early diagnosis of cardiac surgery-associated acute kidney injury: a meta-analysis. Eur J Cardiothorac Surg, 2016, 49(3): 746-755.
10. Cuartero M, Betbesé AJ, Núñez K, et al. Does whole-blood neutrophil gelatinase-associated lipocalin stratify acute kidney injury in critically ill patients?. Dis Markers, 2019, 2019: 8480925.
11. Jonsson N, Gille-Johnson P, Martling CR, et al. Performance of plasma measurement of neutrophil gelatinase-associated lipocalin as a biomarker of bacterial infections in the intensive care unit. J Crit Care, 2019, 53: 264-270.
12. 中华医学会外科学分会胰腺外科学组. 急性胰腺炎诊治指南(2014 版). 中华消化外科杂志, 2015, 14(1): 1-5.
13. 郭锦洲. 改善全球肾脏病预后组织(KDIGO)临床实践指南: 急性肾损伤. 肾脏病与透析肾移植杂志, 2013, 22(1): 57-60.
14. Portelli M, Jones CD. Severe acute pancreatitis: pathogenesis, diagnosis and surgical management. Hepatobiliary Pancreat Dis Int, 2017, 16(2): 155-159.
15. Park HS, In SG, Yoon HJ, et al. Predictive values of neutrophil-lymphocyte ratio as an early indicator for severe acute pancreatitis in the emergency department patients. J Lab Physicians, 2019, 11(3): 259-264.
16. Farkas N, Hanák L, Mikó A, et al. A multicenter, international cohort analysis of 1435 cases to support clinical trial design in acute pancreatitis. Front Physiol, 2019, 10: 1092.
17. Kolber W, Dumnicka P, Maraj M, et al. Does the automatic measurement of interleukin 6 allow for prediction of complications during the first 48 h of acute pancreatitis?. Int J Mol Sci, 2018, 19(6): 1820.
18. Bukosza EN, Kaucsár T, Godó M, et al. Glomerular collagen deposition and lipocalin-2 expression are early signs of renal injury in prediabetic obese rats. Int J Mol Sci, 2019, 20(17): 4266.
19. Al-Naimi MS, Rasheed H, Hussien NR, et al. Nephrotoxicity: role and significance of renal biomarkers in the early detection of acute renal injury. J Adv Pharm Technol Res, 2019, 10(3): 95-99.
20. Forster CS, Devarajan P. Neutrophil gelatinase-associated lipocalin: utility in urologic conditions. Pediatr Nephrol, 2017, 32(3): 377-381.

West China Medical Journal

Correlation of plasma lipocalin-2 with inflammation and predictive value of lipocalin-2 for detecting acute kidney injury in acute pancreatitis

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