Correlation Between Severity of Illness and Levels of Free Triiodothyronine, Interleukin-6, and Interleukin-10 in Patients with Acute Pancreatitis

Abstract

Background Acute pancreatitis (AP) is a common acute abdominal disease. Rapid evaluation of the severity is important for AP prognosis and treatment. Free triiodothyronine (fT3) level is associated with the prognosis of AP patients. This study aimed to investigate the fT3 level in patients with acute pancreatitis; early warning signs of inflammation, including interleukin-6 (IL-6) and interleukin-10 (IL-10); and the correlation of fT3 level with illness severity. Material/Methods Enrolled AP patients (N=312) were divided into an SAP group (N=92) and a non-SAP group (N=220) according to the Revision of Atlanta classification. Blood or tissue samples and baseline clinical characteristics were recorded. The t test and chi-square test were used to evaluate differences between the 2 groups. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used to investigate protective factors. One-way repeated measures analysis of variance was used to evaluate the prognosis of SAP patients. Results In our study, compared with APACHII score (AUC 0.829 [95% CIs 0.769–0.889]) and Ranson score (AUC 0.629 [95% CIs 0.542–0.715]), our predictive model (AUC 0.918 [95% CIs 0.875–0.961]) showed better prognostic performance in predicting poor patient outcomes. In the SAP group, changes in fT3 level were significantly associated with prognosis ( P <0.05). Conclusions The predictive model can improve the diagnostic accuracy and prediction of the severity of disease. FT3 level could be used as an independent risk factor to predict the mortality of SAP patients.

Cytokine Dynamics in Acute Pancreatitis: The Quest for Biomarkers from Acute Disease to Disease Resolution

“…Interestingly, when considering both AP severity scores (BISAP and Atlanta), only IL-6 and VEGF levels consistently emerged as putative reliable markers of disease severity at T2, since both cytokines were elevated at this time point in patients with higher BISAP and Atlanta severity scores. When considering IL-6, these results come as no surprise, but there are very few studies that include VEGF and its role in acute pancreatitis patients; therefore, we can conclude that our study may constitute a milestone in the development of possible new markers for assessing the severity of AP [17,38].…”

Predictive value of machine learning for the severity of acute pancreatitis: A systematic review and meta-analysis

“…These newly identified studies were screened based on the inclusion and exclusion criteria. Finally, a total of 33 original studies [ [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] ] were included. The literature screening process is illustrated in Fig.…”

“…In terms of statistical methods, ten studies [ 17 , 18 , 25 , 26 , [39] , [40] , [41] , 44 , 45 ] had an EPV <10 in the training set, and nine studies [ [20] , [21] , [22] , 24 , 30 , 33 , 34 , 36 , 46 ] were unable to calculate EPV. In addition, eleven studies [ 14 , 16 , 17 , 21 , 22 , 24 , 29 , 30 , 36 , 37 , 39 ] had no independent validation sets or had independent validation sets with fewer than 100 cases. Two studies [ 15 , 18 ] handled missing values in an unreasonable manner.…”

“…Five studies [ 14 , [16] , [17] , [18] , 21 , 34 ] used a univariate screening method. Eighteen studies [ 17 , 19 , 23 , 24 , [27] , [28] , [29] , [30] , [32] , [33] , [34] , [36] , [37] , [38] , [39] , [43] , [44] , [45] ] did not consider the overfitting, underfitting, and optimal fitting of the model. The final assessment result is shown in Fig.…”

The relationship between inflammatory cytokines and in‐hospital complications of acute pancreatitis

“…Excessive TNF‐α enters the blood circulation, and stimulates the production of cytokines (IL‐1β, IL‐6, IL‐8), causing a “waterfall‐like cascade reaction,” leading to a cytokine storm. The correlation between disease severity and cytokine levels of IL‐1β, IL‐6, IL‐8, and IL‐10 has been repeatedly confirmed, but the sensitivity and specificity reported in different literature vary greatly 21–23 . Sternby et al 24 performed paired comparisons of samples collected at 0–24 and 25–48 h after AP onset, and the results showed that IL‐1β, IL‐6, IL‐8, and IL‐10 changed over time, and there were significant differences between different severity groups after 24 h. Ćeranić et al 25 monitored the serum concentrations of IL‐6, IL‐8, and IL‐10 at the admission of AP patients, and compared with IL‐8 and IL‐10, IL‐6 had the highest predictive value for SAP at admission, which is consistent with our study.…”