Kojima Yuichi, Tsuchiya Atsunori, Mito Masaki, Watanabe Yusuke, Kawata Yuzo, Tominaga Kentaro, Terai Shuji
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences Niigata University Niigata Japan.
JGH Open. 2024 Jul 29;8(8):e70009. doi: 10.1002/jgh3.70009. eCollection 2024 Aug.
Neutrophil gelatinase-associated lipocalin (NGAL) is characterized by increased expression before the rise in serum creatinine and has been used as a biomarker for the early prediction of acute kidney injury (AKI). However, there have been no comprehensive analyses of its significance in gastrointestinal diseases. This study aimed to analyze the usefulness of measuring urinary NGAL levels in patients with gastrointestinal diseases.
This study included 171 patients with a wide range of gastrointestinal diseases. Urinary NGAL levels were measured in all patients within 24 h of admission and 72 h later.
Urinary NGAL levels were higher in patients with acute pancreatitis and acute cholangitis/cholecystitis than in those with other diseases. Although lower than in these diseases, urinary NGAL tends to be higher in inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease, as well as in acute and chronic liver diseases, and is higher in liver cirrhosis as the Child-Pugh grade increases. Furthermore, we found that the group with higher urinary NGAL levels, which continued to increase over time, had worse hospital stays and prognosis.
Urinary NGAL could be used as an indicator of infectious diseases rather than an indicator of AKI in inflammatory bowel diseases and cirrhosis, and could predict the prognosis of patients with gastrointestinal diseases.
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的特点是在血清肌酐升高之前表达增加，已被用作急性肾损伤（AKI）早期预测的生物标志物。然而，尚未对其在胃肠道疾病中的意义进行全面分析。本研究旨在分析测量胃肠道疾病患者尿NGAL水平的有用性。
本研究纳入了171例患有各种胃肠道疾病的患者。在所有患者入院后24小时内及72小时后测量尿NGAL水平。
急性胰腺炎和急性胆管炎/胆囊炎患者的尿NGAL水平高于其他疾病患者。虽然低于这些疾病，但溃疡性结肠炎和克罗恩病等炎症性肠病以及急慢性肝病患者的尿NGAL往往较高，且随着Child-Pugh分级增加，肝硬化患者的尿NGAL水平更高。此外，我们发现尿NGAL水平较高且随时间持续升高的组，其住院时间和预后较差。
在炎症性肠病和肝硬化中，尿NGAL可作为传染病的指标而非AKI的指标，并可预测胃肠道疾病患者的预后。
