Superoxide Dismutase Predicts Persistent Circulation Failure and Mortality in the Early Stage of Acute Pancreatitis
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ORIGINAL ARTICLE
Superoxide Dismutase Predicts Persistent Circulation Failure and Mortality in the Early Stage of Acute Pancreatitis Xi Zheng1,2 · Lei Li1,2 · Yin Zhu2 · Xin Huang2 · Yue Zhang1,2 · Bingjun Yu1,2 · Wenhua He2 · Nonghua Lv2 Received: 24 October 2019 / Accepted: 11 January 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objectives Oxidative stress is an important event in the pathogenesis of acute pancreatitis. Superoxide dismutase is a major antioxidant enzyme in the body. The aim of this study was to investigate the changes in superoxide dismutase activity early in the onset of acute pancreatitis and its value in predicting the risk of organ failure and mortality. Methods Data for 2549 patients hospitalized from 2013 to 2017 were extracted from the prospective database, and we selected 854 adult patients who were admitted within 24 h of disease onset with complete data. Serum superoxide dismutase activities on the first, second, and third days of hospital admission for patients with different severities, organ failure, and mortality were compared. The areas under the curve for the prediction of organ failure, pancreatic necrosis, and mortality were estimated using receiver operating characteristic curves. Results Among the 854 adult patients, superoxide dismutase activities were significantly different among patients with mild acute pancreatitis, moderately severe acute pancreatitis, and severe acute pancreatitis (P = 0.005). Superoxide dismutase activity was significantly decreased in patients with persistent renal failure (77.8 ± 37.2), persistent circulatory failure (66.2 ± 14.9), and mortality (64.3 ± 16.0). The accuracy of superoxide dismutase with regard to predicting persistent circulatory failure and mortality was high, and the areas under the receiver operating characteristic curves were 0.83 and 0.84, respectively. Conclusions Superoxide dismutase activity was negatively correlated with the severity and clinical outcome of AP. Superoxide dismutase activity is highly accurate at predicting persistent circulation failure and mortality in the early stage of AP. Keywords Acute pancreatitis · Superoxide dismutase · Persistent circulation failure · Mortality
Introduction Acute pancreatitis (AP) is an inflammatory reaction to pancreatic tissue self-digestion and is characterized by edema, hemorrhage, and even necrosis caused by various mechanisms. Sanfey et al. [1] first proposed that oxygen free Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10620-020-06069-w) contains supplementary material, which is available to authorized users. * Wenhua He [email protected] Nonghua Lv [email protected] 1
Medical College of Nanchang University, Nanchang, People’s Republic of China
Department of Gastroenterology, First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, Nanchang 330006, Jiangxi, People’s Republic of China
2
radicals play an important role in the pathogenesis of AP. In
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