Low serum adiponectin levels are associated with systemic organ failure in acute pancreatitis.
OBJECTIVE
Obesity markedly increases the risk of severe acute pancreatitis (SAP), possibly through the action of adipokines. We tested the hypothesis that serum adiponectin, the primary anti-inflammatory adipokine, is associated with functional polymorphisms in the adiponectin gene (ADIPOQ) and inversely associated with SAP.


METHODS
Severe AP was defined as the presence of remote organ failure. ADIPOQ polymorphisms rs2241766T>G and rs1501299G>T were evaluated by DNA sequencing. Serum samples were assayed using a Luminex assay (Luminex, Austin, Tex).


RESULTS
One hundred thirty-three patients with AP and 94 healthy controls were ascertained. Adiponectin levels were measured in 60 patients with early serum samples (27 patients with mild AP and 33 patients with SAP). Adiponectin levels from days 1 to 3 were inversely correlated with body mass index (BMI) (rho = -0.49; P = 0.002) and were significantly lower for patients with SAP (median, 3.74 microg/mL) than those with mild AP (6.58 microg/mL; P = 0.02). Neither ADIPOQ polymorphism affected susceptibility to or severity of AP. A receiver operating characteristics curve using adiponectin levels as the severity predictor provided an area under the curve of 0.75.


CONCLUSIONS
Serum adiponectin levels in patients with AP are inversely correlated with BMI and organ dysfunction. Further studies are needed to determine whether adiponectin is a marker of low BMI or if it provides significant protection from SAP.
Sharma
Arun
A
Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Muddana
Venkata
V
Lamb
Janette
J
Greer
Julia
J
Papachristou
Georgios I
GI
Whitcomb
David C
DC
D000208:Acute Disease; D052242:Adiponectin / Q000097:blood* / Q000235:genetics; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D015810:Linkage Disequilibrium; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood* / Q000473:pathology; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000097:blood* / Q000235:genetics / Q000473:pathology; D020641:Polymorphism, Single Nucleotide; D017422:Sequence Analysis, DNA; D012720:Severity of Illness Index
D052242:Adiponectin