Pan Jia-Jia, Liu Wei-Li, Lu Guo-Tao, Ma Xing-Jie, Zheng Qing-Bin, Wei Guang-Fa, Tian Ge-Yan, Meng Li-Jun
Department of Intensive Care, The Affiliated Hospital of Yangzhou University, 368 Hanjiang Road, Yangzhou City, Jiangsu Province 225100, China.
Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, 368 Hanjiang Road, Yangzhou City, Jiangsu Province 225100, China.
Gastroenterol Res Pract. 2022 Jun 25;2022:2623199. doi: 10.1155/2022/2623199. eCollection 2022.
Sexual dimorphism with critical diseases has been documented. However, the role of serum sex hormones for the presence of acute kidney injury (AKI) in moderately or severe acute pancreatitis (MSAP and SAP) patients remains controversial. Here we set out to evaluate whether early (first 48 h) serum estradiol level is associated with AKI in patients with MSAP and SAP. . We retrospectively collected data from patients with preliminary diagnosis of MSAP and SAP from the Affiliated Hospital of Yangzhou University between January 2014 and June 2018. Serum sex hormones were extracted for further assessment within first 48 h following admission. Logistic regression analysis and the receiving operating characteristic (ROC) curve were applied to evaluate the association and correlation between serum sex hormones and AKI.
Data from a total of 122 patients with MSAP or SAP were enrolled in this study. There were no differences in the incidence of AKI between males and females. However, comparing with patients without AKI, those with AKI saw higher estradiol level ( ≤ 0.01) and slight higher progesterone level ( = 0.014) but similar testosterone level ( = 0.668). Interestingly, during both the manual selection and the stepwise backward logistic regression analysis, serum estradiol level was independently associated with AKI in patients with MSAP and SAP (OR 4.699, CI 1.783-12.386, and = 0.002). Additionally, area under the curve of ROC (AUCROC) showed that serum estradiol level was a proper predictor for AKI (area under the curve 0.875). Specifically, the serum estradiol level of 223.15 pg/mL demonstrated a 92.3% sensitive and a 79.3% specificity in predicting AKI of MSAP and SAP patients, respectively.
High baseline serum estradiol level appears to be an independent risk factor for AKI in patients with MSAP and SAP. It also tends to be an appropriate indicator for AKI.
已证实重大疾病存在性别差异。然而，血清性激素在中度或重度急性胰腺炎（MSAP和SAP）患者急性肾损伤（AKI）发生中的作用仍存在争议。在此，我们旨在评估早期（最初48小时）血清雌二醇水平与MSAP和SAP患者的AKI是否相关。我们回顾性收集了2014年1月至2018年6月扬州大学附属医院初步诊断为MSAP和SAP患者的数据。入院后最初48小时内提取血清性激素进行进一步评估。应用逻辑回归分析和受试者工作特征（ROC）曲线评估血清性激素与AKI之间的关联和相关性。
本研究共纳入122例MSAP或SAP患者的数据。男性和女性AKI的发生率无差异。然而，与无AKI的患者相比，有AKI的患者雌二醇水平较高（P≤0.01），孕酮水平略高（P = 0.014），但睾酮水平相似（P = 0.668）。有趣的是，在人工选择和逐步向后逻辑回归分析中，血清雌二醇水平均与MSAP和SAP患者的AKI独立相关（OR 4.699，CI 1.783 - 12.386，P = 0.002）。此外，ROC曲线下面积（AUCROC）显示血清雌二醇水平是AKI的合适预测指标（曲线下面积0.875）。具体而言，血清雌二醇水平为223.15 pg/mL时，预测MSAP和SAP患者AKI的敏感性分别为92.3%，特异性为79.3%。
高基线血清雌二醇水平似乎是MSAP和SAP患者发生AKI的独立危险因素。它也倾向于成为AKI的合适指标。
