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001-es BibID:BIBFORM091813
035-os BibID:(cikkazonosító)94
Első szerző:Tornai Dávid (hepatológia, biomarker kutatás)
Cím:Abnormal ferritin levels predict development of poor outcomes in cirrhotic outpatients : a cohort study / David Tornai, Peter Antal-Szalmas, Tamas Tornai, Maria Papp, Istvan Tornai, Nora Sipeki, Tamas Janka, Boglarka Balogh, Zsuzsanna Vitalis
Dátum:2021
ISSN:1471-230X
Megjegyzések:Abstract Background: Both iron overload and iron deficient anemia can associate with cirrhosis. At the same time, inflammation might be continuously present in cirrhotic patients due to bacterial translocation and patients' susceptibility to infections. Ferritin is a sensitive and widely available marker of iron homeostasis, in addition it acts as an acute phase protein. Therefore, we evaluated the prognostic potential of serum ferritin in the longterm follow-up of cirrhotic outpatients. Methods: A cohort of 244 cirrhotic outpatients was recruited and followed for 2 years. We measured their serum ferritin levels in our routine laboratory unit at enrolment and investigated its association with clinical outcomes. Results: Ferritin serum level was higher in males and older patients than in females (median: 152.6 vs. 75 ?g/L, p<0.001) or younger individuals (median: 142.9 vs. 67.9 ?g/L, p=0.002). Patients who previously survived variceal bleeding had lower ferritin levels (median: 43.1 vs. 146.6 ?g/L, p<0.001). In multivariate regression models, including laboratory and clinical factors, lower (<40 ?g/L) ferritin concentration was associated with the development of decompensated clinical stage in patients with previously compensated cirrhosis (sHR: 3.762, CI: 1.616-8.760, p=0.002), while higher (>310 ?g/L) circulating ferritin levels were associated with increased risks of bacterial infections in decompensated patients (sHR: 2.335, CI: 1.193-4.568, p=0.013) and mortality in the whole population (HR: 2.143, CI: 1.174-3.910, p=0.013). Conclusion: We demonstrated usefulness of serum ferritin as a prognostic biomarker in cirrhosis, pointing out that both low and high concentrations need attention in these patients.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Bmc Gastroenterology. - 21 : 1 (2021), p. 1-13. -
További szerzők:Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos) Tornai Tamás István (1984-) (belgyógyász) Papp Mária (1975-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Sipeki Nóra (1987-) (általános orvos) Janka Tamás Balogh Boglárka (1993-) (belgyógyász) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus)
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
DOI
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2.

001-es BibID:BIBFORM089190
Első szerző:Tornai Dávid (hepatológia, biomarker kutatás)
Cím:Increased sTREM-1 levels identify cirrhotic patients with bacterial infection and predict their 90-day mortality / Tornai David, Vitális Zsuzsanna, Jónás Alexa, Janka Tamás, Földi Ildikó, Tornai Tamás, Sipeki Nóra, Csillag Anikó, Balogh Boglárka, Sümegi Andrea, Földesi Róza, Papp Mária, Antal-Szalmás Péter
Dátum:2021
Megjegyzések:Background & Aims: Patients with cirrhosis are susceptible to bacterial infections (BIs) that are major causes of specific complications and mortality. However, the diagnosis of BIs can often be difficult in advanced disease stage since their symptoms may overlap with the ones of acute decompensation (AD). Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is released from monocytes/macrophages and neutrophils during activation and has been reported to correlate with activity of various inflammatory processes. We investigated its diagnostic and prognostic performance in patients with cirrhosis and BI. Methods: Sera of 269 patients were assayed for sTREM-1 by ELISA (172 outpatients and 97 patients with AD of whom 56 had BI). We investigated capacity of sTREM-1 to identify patients with BI and conducted a 90-day follow-up observational study to assess its possible association with short-term mortality. Results: sTREM-1 levels were significantly higher in patients with more severe liver disease, BI, and acute-on-chronic liver failure than in patients without these conditions. sTREM-1 had similar accuracy to CRP identifying BI [sTREM-1: AUROC (95%CI) 0.804 (0.711-0.897), p<0.0001, CRP: 0.791 (0.702-0.881) p<0.0001)] among AD patients. The combination of these two molecules and the presence of ascites into a composite score significantly increased their discriminative power (AUROC:0.878, 95%CI:0.812-0.944, p<0.0001). High sTREM-1 level (>660 pg/mL) was an independent predictor of 90-day mortality in patients with BI [HR: 2.941, (95%CI: 1.009-8.573), p=0.048] in our multivariate model. Conclusions: Use of sTREM-1 could increase the recognition of BIs in cirrhosis and help clinicians in mortality risk assessment of these patients.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
sTREM-1
bacterial infection
cirrhosis
acute decompensation
mortality
Megjelenés:Clinics and Research in Hepatology and Gastroenterology. - 45 : 5 (2021), p. 1-12. -
További szerzők:Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Jónás Alexa Janka Tamás Földi Ildikó (1981-) (orvos) Tornai Tamás István (1984-) (belgyógyász) Sipeki Nóra (1987-) (általános orvos) Csillag Anikó (1979-) (immunológus, biológus, angol-magyar szakfordító) Balogh Boglárka (1993-) (belgyógyász) Sümegi Andrea (1969-) (biológus) Földesi Róza (1967-) (klinikai laboratóriumi kutató, PhD hallgató) Papp Mária (1975-) (belgyógyász, gasztroenterológus) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos)
Pályázati támogatás:GINOP-2.3.2-15-2016-00048
GINOP
EFOP-3.6.1-16-2016- 00022
EFOP
EFOP- 3.6.2-16-2017-00006
EFOP
ÚNKP-19-4
ÚNKP
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
DOI
Borító:
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