title: Total Adiponectin, Adipocyte Fatty Acid Binding Protein, Fibroblast Growth Factor 21 and Proinflammatory Marker Levels During the Early Stage of Acute Pancreatitis--A Pilot Study.
abstract: BACKGROUND
  Recently, an increasing interest has been extended to the secretory products of fat tissue adipokines and their role in the course of acute pancreatitis (AP). The study aimed to evaluate the levels of adiponectin (ADP), adipocyte fatty acid binding protein (A-FABP), fibroblast growth factor (FGF 21), and selected proinflammatory markers during the early stage of acute pancreatitis. The parameters were measured for identification of the patients with the high risk of severe AP.
  
  
  METHODS
  84 subjects (47 males, 37 females) with AP were divided into the subgroups according to body mass index (BMI), disease severity score (mild AP vs. severe AP) and computer tomography severity index score (CTSI A vs. CTSI B vs. CTSI C). All laboratory examinations were determined on day 1 and day 4 after admission. Adipokines were analyzed using the ELISA kit methods.
  
  
  RESULTS
  No significant variance was found in adipokine levels between subjects with mild and severe AP, but C-reactive protein (CRP) and interleukin 6 (IL-6) were significantly elevated in patients with severe AP on day 4 (CRP medians: 209.8 mg/L vs. 51.2 mg/L, p < 0.000; IL-6 medians: 79.5 ng/L vs. 25.9 ng/L, p < 0.01). FGF 21 medians were distinctly higher on day 1 in all observed subgroups compared to day 4 (mild AP: 669.9 ng/L vs. 261.7 ng/L; severe AP: 619.4 ng/L vs. 468.0 ng/L; CTSI A: 631.4 ng/L vs. 246.2 ng/L; CTSI B: 2226.3 ng/L vs. 693.1 ng/L; CTSI C: 572.6 ng/L vs. 310.8 ng/L). Similarly, this phenomenon was found for A-FABP and IL-6 as well. A-FABP and FGF 21 levels decreased during the first four days together, but independently of the IL-6 decline, regardless of AP severity.
  
  
  CONCLUSIONS
  Elevated levels of CRP and IL-6 in subjects with severe form of AP on day 4 indicate a diagnostic utility of both parameters in the disease severity prediction. Increased FGF 21 at admission compared to day 4 suggests its potential role as an immediate response gene during pancreatic injury. The dynamics of FGF 21 and A-FABP levels probably reflect the improvement of clinical condition in the early stage of AP.
authors.forename: Dalibor
authors.initials: D
authors.lastname: Novotny
authors.forename: Pavel
authors.initials: P
authors.lastname: Malina
authors.forename: Petra
authors.initials: P
authors.lastname: Krumpholcova
authors.forename: Igor
authors.initials: I
authors.lastname: Tozzi
mesh_terms: D000208:Acute Disease; D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D015415:Biomarkers; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D003289:Convalescence; D018450:Disease Progression; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D005346:Fibroblast Growth Factors / Q000097:blood* / Q000235:genetics; D017781:Genes, Immediate-Early; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000473:pathology; D010865:Pilot Projects; D012720:Severity of Illness Index
chemical_list: D052242:Adiponectin; D015415:Biomarkers; C493410:FABP4 protein, human; D050556:Fatty Acid-Binding Proteins; C508600:IL6 protein, human; D015850:Interleukin-6; C414620:fibroblast growth factor 21; D005346:Fibroblast Growth Factors; D002097:C-Reactive Protein