Retinol-binding protein-4 expression marks the short-term mortality of critically ill patients with underlying liver disease: Lipid, but not glucose, matters

Chen, Wei‐Ting; Lee, Mu-Shien; Chang, Chia‐Lin; Chiu, Cheng‐Tang; Chang, Ming‐Ling

doi:10.1038/s41598-017-03096-y

Cited by 7 publications

(5 citation statements)

References 47 publications

(56 reference statements)

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“… 28 A low concentration of RBP at baseline was found associated with a bad outcome in liver ICU patients, which could predict short-term mortality of the patients, but not long-term mortality. 29 Consistent with these findings, we also present here that RBP level is specifically reduced in the non-survived pneumonia population of the study, indicating that low RBP was the main risk factor for in-hospital mortality in critical pneumonia patients. The predictive performance of the baseline RBP was much better than the severity scoring systems other than CURB-65, which demonstrates it as a better predictor in severe comorbidities.…”

Section: Discussionsupporting

confidence: 90%

A Prognostic Model for In-Hospital Mortality in Critically Ill Patients with Pneumonia

Le¹,

Zhang²,

Wang³

et al. 2022

IDR

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Purpose To determine the utility of a novel serum biomarker for the outcome prediction of critically ill patients with pneumonia. Patients and Methods A retrospective analysis of critically ill patients was performed at an emergency department. The expression and prediction value of parameters were assessed. Binary logistic regression analysis was utilized to determine the indicators associated with in-hospital mortality of pneumonia patients. The Last Absolute Shrinkage and Selection Operator was used to further determine the independent predictors, which were validated by multiple logistic regression. The receiver operator characteristic curve was performed to assess their prediction values. A prognostic nomogram model was finally established for the outcome prediction for critically ill patients with pneumonia. Results Retinol-binding protein (RBP) was significantly reduced in non-survived and pneumonia patients. CURB-65 score, levels of RBP, and blood urea nitrogen (BUN) were associated with in-hospital mortality of critically ill patients with pneumonia. Their combination was determined to be an ideal prognostic predictor (area under the curve of 0.762) and further developed into a nomogram prediction model (c-index 0.764). Conclusion RBP is a novel in-hospital mortality predictor, which well supplements the CURB-65 score for critical pneumonia patients.

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Section: Discussionsupporting

confidence: 90%

A Prognostic Model for In-Hospital Mortality in Critically Ill Patients with Pneumonia

Le¹,

Zhang²,

Wang³

et al. 2022

IDR

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“…Similar results were found in the study of patients with ischaemic stroke, showing that elevated serum levels of RBP4 were associated with the severity and poor prognosis of acute ischaemic stroke . However, another two studies of patients admitted in intensive care unit found that low serum RBP4 levels were related to increased mortality in patients with acute exacerbations of chronic obstructive pulmonary disease and underlying liver disease, respectively. The decreased RBP4 levels might attribute to the malnutritional status in these critically ill patients, because circulating RBP4 concentration depends on vitamin A status .…”

Section: Discussionsupporting

confidence: 82%

Serum retinol‐binding protein 4 as a predictor of cardiovascular events in elderly patients with chronic heart failure

Zhang

Yan

et al. 2020

ESC Heart Failure

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Aims RBP4 is an adipokine with adverse effects on cardiovascular system. Increased circulating retinol-binding protein 4 (RBP4) has been linked to chronic heart failure (CHF). However, whether elevated RBP4 is correlated with a poor prognosis in elderly patients with CHF remains unclear. The aim of this study was to evaluate the prognostic value of serum RBP4 in elderly patients with CHF. Methods and results We enrolled 934 consecutive elderly patients (aged 60 years and older) with CHF and 138 age-matched and sex-matched control subjects in a prospective cohort study and explored the association of serum RBP4 levels with the clinical outcomes using multivariate Cox regression analyses. Serum RBP4 levels were elevated in CHF patients when compared with controls (46.66 ± 12.38 μg/mL vs. 40.71 ± 7.2 μg/mL, P < 0.001). Patients with the highest RBP4 concentrations had higher N terminal pro brain natriuretic peptide (NT-proBNP) levels but lower left ventricular eject fraction (LVEF) and estimated glomerular filtration rate (P < 0.001). Serum RBP4 levels were increased as the New York Heart Association functional class increased and LVEF decreased (P < 0.001) and were negatively correlated with LVEF (r = À0.154, P < 0.001) but positively correlated with NT-proBNP levels (r = 0.074, P = 0.023). Multivariate Cox regression analysis suggested that log RBP4 was an independent predictor for major adverse cardiac event(s) [hazard ratio (HR) = 2.61, 95% confidence interval (CI) = 1.19-5.70], together with age, male, LVEF, log NT-proBNP, and estimated glomerular filtration rate. Moreover, log RBP4 was also an independent predictor for cardiovascular mortality (HR = 2.24, 95% CI = 1. 35-5.39) and CHF rehospitalization (HR = 2.54, 95% CI = 1.09-5.60) even after adjustment for the established adverse prognostic factors for CHF. The Kaplan-Meier survival curves showed that high concentration of RBP4 was a prognostic indicator of major adverse cardiac event(s) in patients with CHF. Conclusions Our findings demonstrate for the first time that elevated serum RBP4 is correlated with worse outcome in elderly patients with CHF.

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“…In contrast, Chen et al demonstrated that baseline RBP levels predicted short-term mortality in critically ill patients with underlying liver disease. Interestingly, in this analysis, those patients that survived ICU treatment displayed significantly increased RBP4 levels after ICU discharge [70], highlighting the potential of this biomarker in predicting survival in patients treated on a medical ICU.…”

Section: Selected Adipokines With a Potential Role In Critical Illmentioning

confidence: 99%

The Role of Adipokines as Circulating Biomarkers in Critical Illness and Sepsis

Loosen

Koch

Tacke

et al. 2019

IJMS

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Sepsis represents a major global health burden. Early diagnosis of sepsis as well as guiding early therapeutic decisions in septic patients still represent major clinical challenges. In this context, a whole plethora of different clinical and serum-based markers have been tested regarding their potential for early detection of sepsis and their ability to stratify patients according to their probability to survive critical illness and sepsis. Adipokines represent a fast-growing class of proteins that have gained an increasing interest with respect to their potential to modulate immune responses in inflammatory and infectious diseases. We review current knowledge on the role of different adipokines in diagnostic work-up and risk stratification of sepsis as well as critical illness. We discuss recent data from animal models as well as from clinical studies and finally highlight the limitations of these analyses that currently prevent the use of adipokines as biomarkers in daily practice.

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Retinol-binding protein-4 expression marks the short-term mortality of critically ill patients with underlying liver disease: Lipid, but not glucose, matters

Cited by 7 publications

References 47 publications

A Prognostic Model for In-Hospital Mortality in Critically Ill Patients with Pneumonia

A Prognostic Model for In-Hospital Mortality in Critically Ill Patients with Pneumonia

Serum retinol‐binding protein 4 as a predictor of cardiovascular events in elderly patients with chronic heart failure

The Role of Adipokines as Circulating Biomarkers in Critical Illness and Sepsis

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