Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, 33521, Finland.
Fimlab Laboratories, Arvo Ylpön katu 4, 33520 Tampere, Finland.
Eur J Intern Med. 2019 Jun;64:72-75. doi: 10.1016/j.ejim.2019.04.007. Epub 2019 May 3.
Soluble urokinase plasminogen activator receptor (suPAR) is a biomarker associated with inflammatory and certain malignancies. Earlier we have shown that plasma suPAR (P-suPAR) predicts severity of acute alcohol-induced pancreatitis (AAP) on admission. Our aim was to investigate whether P-suPAR levels predict AAP recurrences or mortality during long-term follow-up after first AAP.
Eighty-three patients (median age 47.5, range 25-71 years) suffering their first AAP during 2001-2005 were recruited and followed prospectively for 9 years with a median follow-up time of 7.0 (range 0.3-9.8) years. P-suPAR was measured by enzyme-linked immunosorbent assay (ELISA) from the samples taken at follow-up visits. Survival was registered in November 2014.
P-suPAR level on admission or after recovery of the first AAP did not predict the recurrence of AAP. However, higher P-suPAR measured after recovery of first AAP (3.6 vs. 2.9 ng/mL) predicted mortality during follow-up period (hazard ratio 1.48, p = .008). Cut-off value for P-suPAR indicating a higher risk for 10-year mortality resulted a value of ≥3.4 ng/mL. When adjusted for other covariates, P-suPAR above cut-off level retained its statistical significance as an independent factor.
P-suPAR level on admission or after recovery of the first AAP does not predict the recurrence of AAP during long-term follow-up. However, P-suPAR ≥3.4 mg/mL measured after recovery from first AAP is associated with an increased risk of 10-year mortality as an independent factor. This can be used to detect patients with highest risk after AAP, in order to focus the preventive healthcare actions.
可溶性尿激酶型纤溶酶原激活物受体（suPAR）是与炎症和某些恶性肿瘤相关的生物标志物。我们之前的研究表明，血浆 suPAR（P-suPAR）可预测入院时急性酒精性胰腺炎（AAP）的严重程度。我们的目的是研究在首次 AAP 后进行的长期随访中，P-suPAR 水平是否可预测 AAP 的复发或死亡率。
2001-2005 年间首次患有 AAP 的 83 名患者（中位年龄 47.5 岁，范围 25-71 岁）入选并进行前瞻性随访，中位随访时间为 7.0 年（范围 0.3-9.8 年）。在随访时通过酶联免疫吸附测定（ELISA）测量 P-suPAR。生存情况于 2014 年 11 月进行登记。
入院时或首次 AAP 恢复后的 P-suPAR 水平均不能预测 AAP 的复发。然而，在首次 AAP 恢复后测量的较高的 P-suPAR（3.6 vs. 2.9ng/mL）预示着随访期间的死亡率（风险比 1.48，p=0.008）。P-suPAR 指示 10 年死亡率风险较高的截断值为≥3.4ng/mL。当调整其他协变量时，高于截断值的 P-suPAR 仍然是独立的预测因素。
入院时或首次 AAP 恢复后的 P-suPAR 水平不能预测长期随访中的 AAP 复发。然而，在首次 AAP 恢复后测量的 P-suPAR 值≥3.4ng/mL 与 10 年死亡率风险增加相关，是一个独立的危险因素。这可用于检测 AAP 后风险最高的患者，以便集中进行预防保健措施。
