Abstract
Objective This study aimed to evaluate the potential effect of hyperhomocysteinemia on multiple organ failure (MOF) in patients with acute pancreatitis (AP). Method In this cohort study, a total of 1880 AP patients were enrolled and divided into the hyperhomocysteinemia group (study group) and the control group based on serum homocysteine (HCY) levels. Clinical data including demographics, clinical outcomes, and characteristics were collected for analysis. Risk factors of MOF in AP patients were determined by univariate and multivariate logistic regression analyses. Results The hyperhomocysteinemia group showed higher multiple organ failure rates (31.83% vs 20.77%, P < 0.001), compared with the control group. A positive correlation between homocysteine level and APACHE II score was obtained by Pearson correlation analysis (r = 0.420, P < 0.001), compared with the control group. A positive correlation between homocysteine level and APACHE II score was obtained by Pearson correlation analysis (P < 0.001), compared with the control group. A positive correlation between homocysteine level and APACHE II score was obtained by Pearson correlation analysis (Conclusion A high serum homocysteine level may be an independent risk factor of multiple organ failure in patients with acute pancreatitis.
Highlights
Acute pancreatitis (AP) is one of the most common gastrointestinal inflammatory diseases, and the majority of AP patients usually experienced a mild course
It was reported that the level of serum HCY in patients with chronic pancreatitis was significantly higher than that of the healthy population [5], and the level of serum HCY was positively correlated with the incidence of pancreatitis [6]
331 patients were excluded, due to Refusal to participate in the study (n = 176) Aged
Summary
Acute pancreatitis (AP) is one of the most common gastrointestinal inflammatory diseases, and the majority of AP patients usually experienced a mild course. Approximately 20% of AP patients could further progress into persistent organ failure and develop severe AP, resulting in high morbidity and mortality. It is still a great challenge to quickly and effectively screen out AP patients with high risk of persistent organ failure during clinical management. Previous reports have shown that many biomarkers such as triglycerides, high-density lipoprotein, and apolipoprotein A could be important predictors of persistent organ failure in AP patients [1, 2]. Homocysteine (HCY) is a sulfur-containing amino acid that has currently been recognized as an independent risk factor for cardiovascular, cerebrovascular, and peripheral vascular diseases [3, 4]. Hyperhomocysteinemia (high level of HCY) is considered a modifiable risk factor for stroke, possibly through an atherogenic and prothrombotic mechanism [7]. HCY is associated with thrombosis and inflammation, and hyperhomocysteinemia may lead to increased oxidative stress, resulting into the formation of inflammation
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