BACKGROUND Acute pancreatitis(AP),a severe pancreatic inflammatory condition,with a mor-tality rate reaching up to 40%.Recently,AP shows a steadily elevating prevalence,which causes the greater number of hospital admi...BACKGROUND Acute pancreatitis(AP),a severe pancreatic inflammatory condition,with a mor-tality rate reaching up to 40%.Recently,AP shows a steadily elevating prevalence,which causes the greater number of hospital admissions,imposing the substantial economic burden.Acute kidney injury(AKI)complicates take up approximately 15%of AP cases,with an associated mortality rate of 74.7%-81%.AIM To evaluate the efficacy of estimated plasma volume status(ePVS)in forecasting AKI in patients with AP.METHODS In this retrospective cohort study,AP cases were recruited from the First College of Clinical Medical Science of China Three Gorges University between January 2019 and October 2023.Electronic medical records were adopted for data extrac-tion,including demographic data and clinical characteristics.The association between ePVS and AKI was analyzed using multivariate logistic regression models,with potential confounders being adjusted.Nonlinear relationship was examined with smooth curve fitting,and infection points were calculated.Further analyses were performed on stratified subgroups and interaction tests were conducted.RESULTS Among the 1508 AP patients,251(16.6%)developed AKI.ePVS was calculated using Duarte(D-ePVS)and Kaplan-Hakim(KH-ePVS)formulas.After adjusting for covariates,the AKI risk exhibited 46%[odds ratio(OR)=1.46,95%confidence interval(CI):0.96-2.24]and 11%(OR=1.11,95%CI:0.72-1.72)increases in the low tertile(T1)of D-ePVS and KH-ePVS,respectively,and 101%(OR=2.01,95%CI:1.31-3.05)and 51%(OR=1.51,95%CI:1.00-2.29)increases in the high tertile(T3)relative to the reference tertile(T2).Nonlinear curve fitting revealed a U-shaped association of D-ePVS with AKI and a J-shaped association for KH-ePVS,with inflection points at 4.3 dL/g and-2.8%,res-pectively.Significant interactions were not observed in age,gender,hypertension,diabetes mellitus,sequential organ failure assessment score,or AP severity(all P for interaction>0.05).CONCLUSION Our results indicated that ePVS demonstrated the nonlinear association with AKI incidence in AP patients.A U-shaped curve was observed with an inflection point at 4.3 dL/g for the Duarte formula,and a J-shaped curve at-2.8%for the Kaplan-Hakim formula.展开更多
Iodine is an element that is essential for the synthesis of thyroid hormones.Adequate intake of dietary iodine has been recognized as a critical factor for maintaining health.It is a well-known fact that iodine defici...Iodine is an element that is essential for the synthesis of thyroid hormones.Adequate intake of dietary iodine has been recognized as a critical factor for maintaining health.It is a well-known fact that iodine deficiency can impede the production of thyroid hormones in both the mother and fetus,which increases the risk of brain damage in the fetal stage.展开更多
文摘BACKGROUND Acute pancreatitis(AP),a severe pancreatic inflammatory condition,with a mor-tality rate reaching up to 40%.Recently,AP shows a steadily elevating prevalence,which causes the greater number of hospital admissions,imposing the substantial economic burden.Acute kidney injury(AKI)complicates take up approximately 15%of AP cases,with an associated mortality rate of 74.7%-81%.AIM To evaluate the efficacy of estimated plasma volume status(ePVS)in forecasting AKI in patients with AP.METHODS In this retrospective cohort study,AP cases were recruited from the First College of Clinical Medical Science of China Three Gorges University between January 2019 and October 2023.Electronic medical records were adopted for data extrac-tion,including demographic data and clinical characteristics.The association between ePVS and AKI was analyzed using multivariate logistic regression models,with potential confounders being adjusted.Nonlinear relationship was examined with smooth curve fitting,and infection points were calculated.Further analyses were performed on stratified subgroups and interaction tests were conducted.RESULTS Among the 1508 AP patients,251(16.6%)developed AKI.ePVS was calculated using Duarte(D-ePVS)and Kaplan-Hakim(KH-ePVS)formulas.After adjusting for covariates,the AKI risk exhibited 46%[odds ratio(OR)=1.46,95%confidence interval(CI):0.96-2.24]and 11%(OR=1.11,95%CI:0.72-1.72)increases in the low tertile(T1)of D-ePVS and KH-ePVS,respectively,and 101%(OR=2.01,95%CI:1.31-3.05)and 51%(OR=1.51,95%CI:1.00-2.29)increases in the high tertile(T3)relative to the reference tertile(T2).Nonlinear curve fitting revealed a U-shaped association of D-ePVS with AKI and a J-shaped association for KH-ePVS,with inflection points at 4.3 dL/g and-2.8%,res-pectively.Significant interactions were not observed in age,gender,hypertension,diabetes mellitus,sequential organ failure assessment score,or AP severity(all P for interaction>0.05).CONCLUSION Our results indicated that ePVS demonstrated the nonlinear association with AKI incidence in AP patients.A U-shaped curve was observed with an inflection point at 4.3 dL/g for the Duarte formula,and a J-shaped curve at-2.8%for the Kaplan-Hakim formula.
基金sponsored by the Young Scholar Scientific Research Foundation of the National Institute of Nutrition and Health of China CDC[Grant No:NINH2016001]
文摘Iodine is an element that is essential for the synthesis of thyroid hormones.Adequate intake of dietary iodine has been recognized as a critical factor for maintaining health.It is a well-known fact that iodine deficiency can impede the production of thyroid hormones in both the mother and fetus,which increases the risk of brain damage in the fetal stage.
