[Hyperlipoproteinemia in necrotizing pancreatitis].
Oxygen free radicals (OFR) generated during necrotizing acute pancreatitis (NAP) make an impact on cholesterol, phospholipids, and triglyceride metabolism. These compounds are poorly soluble in body fluids and form proteolipid complexes called lipoproteins. The aim of this study is to investigate the lipoprotein metabolism in accordance to NAP severity.


METHODS
Sixty patients with NAP were included to this study, 41 males and 19 females. Patients mean Ranson score exceeded 7 points. The severity of the disease and overall patient standing changes were monitored by means of APACHE II score. In all patients indications for surgery performed between 15th and 30th day of observation were signs of infection. All patients were divided into 2 groups. Group I included 42 patients, who survived the 30-day observation period. Group 2 was made of 18 patients who died. The total high density lipoproteins (HDL) and low density proteins (LDL) of lipoprotein fraction concentrations were measured on 1st, 5th, 10h, and 15th day of treatment. Concentrations of cholesterol, triglyceride, and phospholipids were measured in isolated fractions.


RESULTS
HDL concentrations measured by means of cholesterol, triglyceride, and phospholipids levels decreased insignificantly in group 1, while in group 2 respective levels were significantly higher and increased along with patient deterioration. Lipoprotein levels showed correlation with patient APACHE II score.


CONCLUSIONS
In the most severe NAP the decrease of high-density and increase of low-density lipoprotein fraction were observed. The assessment of lipoprotein metabolism derangement may be a useful prognostic factor in NAP.
Modzelewski
Bogdan
B
Klinika Chirurgii Ogólnej i Gastroenterologicznej Uniwersytetu Medycznego, Lodzi. bogdanm@ventura.pl
Janiak
Adam
A
Hołlyński
Jarosław
J
D018806:APACHE; D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood; D005260:Female; D005609:Free Radicals / Q000378:metabolism*; D006801:Humans; D006951:Hyperlipoproteinemias / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000378:metabolism* / Q000601:surgery; D010743:Phospholipids / Q000097:blood; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D014280:Triglycerides / Q000097:blood
D005609:Free Radicals; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D010743:Phospholipids; D014280:Triglycerides; D002784:Cholesterol