title: Patterns of correlation of plasma ceruloplasmin in sepsis.
abstract: BACKGROUND
  In sepsis, plasma ceruloplasmin (Cp, mg/L) is known to increase as part of the acute phase response. However, there is poor knowledge of the patterns of increase and correlation with changes in other biochemical variables, and our study has been performed to investigate this aspect.
  
  
  METHODS
  A total of 213 simultaneous measurements of Cp and other acute phase proteins, biochemical variables, and amino acids were performed on nine patients with severe sepsis, and processed by regression analysis.
  
  
  RESULTS
  Mean Cp was 478 +/- 119 mg/L (median 488, range 242-784). Significant direct correlations between Cp and C-reactive protein, alpha-1-antitrypsin and alpha-2-macroglobulin (P < 0.001 for all) were all simultaneously influenced by the level of alkaline phosphatase, which was an independent determinant of increased Cp (P < 0.001). Cp increased further with decreasing plasma pH and increasing triglyceride, taurine levels, and distance from the onset of sepsis (P < 0.001 for all). The maximum increases in Cp were associated with the presence of cholestasis, increasing triglyceride levels, and metabolic acidosis. With regard to septic liver dysfunction, while signs of cholestasis were mostly reflected in greater increases in Cp, increasing bilirubin in the presence of normal alkaline phosphatase was mostly correlated with abnormal increases in cyst(e)ine, cystathionine, and tyrosine levels.
  
  
  CONCLUSIONS
  These data characterize the patterns of correlation of Cp within the biochemical abnormalities of sepsis, and may provide new insights into the pathophysiology of septic hepatobiliary dysfunction.
authors: IASI-CNR Center for Pathophysiology of Shock, Catholic University School of Medicine, Rome, Italy. carlo.chiarla@rm.unicatt.it
authors: Carlo
authors: C
authors: Chiarla
authors: Ivo
authors: I
authors: Giovannini
authors: John H
authors: JH
authors: Siegel
mesh_terms: D000210:Acute-Phase Reaction / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D000596:Amino Acids / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002570:Ceruloplasmin / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D012044:Regression Analysis; D018805:Sepsis / Q000097:blood* / Q000503:physiopathology; D014280:Triglycerides / Q000097:blood
chemical_list: D000596:Amino Acids; D014280:Triglycerides; D002097:C-Reactive Protein; D002570:Ceruloplasmin; D000469:Alkaline Phosphatase; D001663:Bilirubin