白细胞介素-6与急性胰腺炎患者的肥胖、中心性脂肪分布及疾病严重程度相关。

Interleukin-6 is associated with obesity, central fat distribution, and disease severity in patients with acute pancreatitis.

作者信息

Park Jongwon, Chang Jae Hyuck, Park Sang Hi, Lee Hee Jin, Lim Yeon Soo, Kim Tae Ho, Kim Chang Whan, Han Sok Won

机构信息

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Pancreatology. 2015 Jan-Feb;15(1):59-63. doi: 10.1016/j.pan.2014.11.001. Epub 2014 Nov 18.

DOI:10.1016/j.pan.2014.11.001

PMID:25434497

Abstract

BACKGROUND/OBJECTIVE: Acute pancreatitis (AP) is a systemic inflammatory disease, and cytokines are suggested to be related to the course of AP. Obesity and central fat distribution are considered to have been associated with severe AP. This study investigated the profile of inflammatory cytokines in AP to determine how they are related to obesity, central fat distribution, and AP severity.

METHODS

Fifty-nine patients with AP were prospectively enrolled in the study. Body mass index and waist circumference were obtained at admission. Serum levels of inflammatory cytokines, IL-Iβ, IL-1ra, IL-6, TNF-α, sTNFR-I, and sTNFR-II, were measured on day 1 and 2 of AP.

RESULTS

Of the patients included in the study, 19 (32%) were overweight, 23 (39%) had central fat distribution, and 23 (39%) had moderate AP. IL-1ra and IL-6 were significantly higher in overweight patients compared with non-overweight patients. IL-1ra, IL-6, TNF-α, and sTNFR-I were significantly higher in patients with central fat distribution compared with patients with non-central fat distribution. IL-6, sTNFR-I, and sTNFR-II were significantly higher in patients with moderate pancreatitis compared to those with mild pancreatitis. Among the six cytokines, IL-6 was commonly elevated in patients with central fat distribution, overweight, and moderate AP. The areas under the receiver operating characteristic curves of IL-6 for predicting the association with overweight, central fat distribution, and AP severity were 0.678, 0.716, and 0.801, respectively (P < 0.05).

CONCLUSIONS

IL-6 is a good marker for AP severity and is associated with obesity and central fat distribution in AP patients.

摘要

背景/目的：急性胰腺炎（AP）是一种全身性炎症性疾病，细胞因子被认为与AP的病程有关。肥胖和中心性脂肪分布被认为与重症AP有关。本研究调查了AP患者炎症细胞因子的概况，以确定它们与肥胖、中心性脂肪分布及AP严重程度之间的关系。

方法

前瞻性纳入59例AP患者。入院时测量体重指数和腰围。在AP第1天和第2天检测血清炎症细胞因子白细胞介素-1β（IL-1β）、白细胞介素-1受体拮抗剂（IL-1ra）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、可溶性肿瘤坏死因子受体-Ⅰ（sTNFR-Ⅰ）和可溶性肿瘤坏死因子受体-Ⅱ（sTNFR-Ⅱ）水平。

结果

研究纳入的患者中，19例（32%）超重，23例（39%）有中心性脂肪分布，23例（39%）为中度AP。与非超重患者相比，超重患者的IL-1ra和IL-6显著更高。与非中心性脂肪分布患者相比，中心性脂肪分布患者的IL-1ra、IL-6、TNF-α和sTNFR-Ⅰ显著更高。与轻度胰腺炎患者相比，中度胰腺炎患者的IL-6、sTNFR-Ⅰ和sTNFR-Ⅱ显著更高。在这六种细胞因子中，IL-6在有中心性脂肪分布、超重和中度AP的患者中普遍升高。IL-6预测与超重、中心性脂肪分布及AP严重程度相关性的受试者工作特征曲线下面积分别为0.678、0.716和0.801（P<0.05）。