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Obesity and pro-inflammatory mediators are associated with acute kidney injury in patients with A/H1N1 influenza and acute respiratory distress syndro

tetano

Editor, Senior Moderator
Exp Mol Pathol. 2014 Oct 8. pii: S0014-4800(14)00166-X. doi: 10.1016/j.yexmp.2014.10.006. [Epub ahead of print]
Obesity and pro-inflammatory mediators are associated with acute kidney injury in patients with A/H1N1 influenza and acute respiratory distress syndrome.
Cruz-Lagunas A1, Jimenez-Alvarez L1, Ram?rez G1, Mendoza-Milla C2, Garc?a-Sancho MC1, Avila-Moreno F3, Zamudio P1, Urrea F1, Ortiz-Quintero B1, Campos-Toscuento VL1, Mor?n J1, Barrera AA1, Mart?nez-Brise?o D1, Fern?ndez-Plata R1, Sierra-Vargas MP1, Mu?oz-Perea C1, Illescas-Flores S1, Bautista E1, Suratt BT4, P?rez-Padilla JR1, Zu?iga J5.
Author information
Abstract
BACKGROUND:

The obesity has been shown to increase the severity of A/H1N1 infection and the development of acute respiratory distress syndrome (ARDS) and organ involvement.
METHODS:

Circulating levels of C-peptide, insulin, glucagon, leptin, acute phase reactants (procalcitonin, C-reactive protein, tissue plasminogen activator, and serum amyloids A and P), were measured in samples from 32 critically ill patients with A/H1N1 virus infection, 17 of whom had ARDS complicated by acute kidney injury (AKI) and 15 of whom had ARDS but did not develop AKI.
RESULTS:

Patients with ARDS and AKI (ARDS/AKI) had higher BMI and higher levels of C-peptide, insulin, leptin, procalcitonin, serum amyloid A compared to those ARDS patient who did not develop AKI. Adjusting for confounding variables using logistic regression analysis, higher levels of C-peptide (>0.75ng/mL) (OR=64.8, 95% CI=2.1-1980, p=0.0006) and BMI >30Kg/m2 (OR=42.0, 95% CI=1.2-1478, p=0.04) were significantly associated with the development of AKI in ARDS patients.
CONCLUSION:

High levels of C-peptide and BMI>30kg/m2 were associated with the development of AKI in ARDS patients due to A/H1N1 infection. These metabolic/obesity indicators, together with the profiles of pro-inflammatory acute phase proteins, may be important links between obesity and poor outcomes in A/H1N1 09 infection.

Copyright ? 2014. Published by Elsevier Inc.
KEYWORDS:

A/H1N1 influenza infection; AKI; C-peptide; Insulin; acute kidney injury; leptin

PMID:
25305354
[PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25305354
 
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