C-reactive protein -717C>T genetic polymorphism associates with esophagectomy-induced stress hyperglycemia.
BACKGROUND
Stress hyperglycemia refers to the transient hyperglycemia seen during illness and is usually restricted to patients without previous evidence of diabetes. The influence of genetics on surgery-induced hyperglycemia remains only partially understood.


METHODS
The study participants were Japanese patients treated for thoracic esophageal cancer with curative esophagectomy at Akita University Hospital between 2003 and 2007. We determined the associations between esophagectomy-induced stress hyperglycemia (> or =30 mg/dl increases in blood glucose during surgery) and genetic polymorphisms for C-reactive protein (CRP), tumor necrosis factor (TNF)-alpha, -beta, interferon-gamma, transforming growth factor-beta1, interleukin (IL)-1beta, IL-2, IL-4, IL-6, IL-6 receptors, IL-10, IL-12beta, adiponectin, and peroxisome proliferator-activated receptor-gamma.


RESULTS
In 28 (46%) patients, blood glucose levels increased more than 30 mg/dl during surgery. Among the genetic polymorphisms tested, CRP -717C>T was significantly associated with stress hyperglycemia during esophagectomy. Multivariate logistic regression revealed that patients with the CRP -717T/T genotype had a significantly greater risk of developing surgery-induced hyperglycemia than those with the CRP -717C/T genotype. Stress hyperglycemia was also significantly associated with postoperative infectious complications and duration of intensive care unit stay.


CONCLUSIONS
It is suggested that CRP -717 C>T genetic polymorphism may be a predictive factor for stress hyperglycemia in patients receiving esophagectomy for thoracic esophageal cancer.
Motoyama
Satoru
S
Department of Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. motoyama@doc.med.akita-u.ac.jp
Miura
Masatomo
M
Hinai
Yudai
Y
Maruyama
Kiyotomi
K
Murata
Katsuyuki
K
Ogawa
Jun-Ichi
J
D052242:Adiponectin / Q000235:genetics; D000368:Aged; D002097:C-Reactive Protein / Q000235:genetics*; D016207:Cytokines / Q000235:genetics; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D047495:PPAR gamma / Q000235:genetics; D011110:Polymorphism, Genetic; D011237:Predictive Value of Tests; D012189:Retrospective Studies
D052242:Adiponectin; D016207:Cytokines; D047495:PPAR gamma; D002097:C-Reactive Protein