Early Prediction of Persistent Organ Failure by Serum Angiopoietin-2 in Patients with Acute Pancreatitis

Dig Dis Sci. 2016 Dec;61(12):3584-3591. doi: 10.1007/s10620-016-4323-y. Epub 2016 Sep 29.

Abstract

Background: Biomarkers for the early prediction of the severity of acute pancreatitis (AP) are urgently needed for clinical management of the disease. Angiopoietin-2 (Ang-2), one of the autocrine peptides that reduce endothelial permeability, has been found to be associated with various diseases, including inflammatory disorders.

Aims: This study aimed to determine whether serum Ang-2 could serve as a noninvasive biomarker for the early prediction of persistent organ failure (POF) in acute pancreatitis.

Methods: A total of 120 AP patients were prospectively enrolled at Jinling Hospital. Serum samples were collected on admission. Clinical and laboratory data were recorded. Ang-2 levels were measured by enzyme-linked immunosorbent assay.

Results: A total of 37 patients developed POF and were classified as having severe AP (SAP). Ang-2 was significantly higher on admission in patients who developed POF than in those who did not (p < 0.001 for all). Furthermore, receiver operating characteristic (ROC) curve analysis revealed that Ang-2 could distinguish patients who developed POF from mild AP (MAP, area under ROC curve [AUC] = 0.88, 95 % CI 0.78-0.94) and moderately severe AP patients (MSAP, AUC = 0.74, 95 % CI 0.63-0.83). In addition, multivariate logistic regression showed that increased Ang-2 was an independent predictor of developing POF between subgroups with MSAP and SAP (OR 7.2, 95 % CI 2.7-19.4) and among all AP patients (OR 12.1, 95 % CI 4.8-30.3).

Conclusions: Elevated serum Ang-2 levels on admission may be a promising biomarker for the prediction of POF in AP.

Keywords: Acute pancreatitis; Angiopoietin-2; Early prediction; Persistent organ failure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • APACHE
  • Acute Disease
  • Adult
  • Angiopoietin-2 / blood*
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / epidemiology
  • Cohort Studies
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Gallstones / complications
  • Humans
  • Hyperlipidemias / complications
  • Logistic Models
  • Male
  • Middle Aged
  • Multiple Organ Failure / blood*
  • Multiple Organ Failure / epidemiology
  • Multivariate Analysis
  • Pancreatitis / blood*
  • Pancreatitis / epidemiology
  • Pancreatitis / etiology
  • Pancreatitis, Alcoholic / blood
  • Pancreatitis, Alcoholic / epidemiology
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Renal Insufficiency / blood*
  • Renal Insufficiency / epidemiology
  • Respiratory Insufficiency / blood*
  • Respiratory Insufficiency / epidemiology
  • Severity of Illness Index

Substances

  • ANGPT2 protein, human
  • Angiopoietin-2
  • Biomarkers
  • C-Reactive Protein