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Coagulopathy and the prognostic potential of D-dimer in hyperlipidemia-induced acute pancreatitis |
Ning Yang, Dong-Lei Zhang and Jian-Yu Hao |
Beijing, China
Author Affiliations: Department of Endocrinology (Yang N) and Department of Gastroenterology (Zhang DL and Hao JY), Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Corresponding Author: Jian-Yu Hao, MD, Department of Gastroenterology, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing 100020, China (Tel: +86- 10-85231714; Fax: +86-10-85231520; Email: haojianyucyyy@sina.com) |
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Abstract BACKGROUND: Coagulopathy and its association with disease severity in hyperlipidemia (HL)- and non-hyperlipidemia (NHL)-induced acute pancreatitis (AP) are not clear. The present study was to evaluate the relationship between coagulation homeostasis and AP.
METHODS: This study included 106 AP patients admitted to our hospital between October 2011 and January 2013. Stratified by disease severity, the patients were divided into two groups: a mild AP (MAP) group (n=69); and a moderately severe AP (MSAP) group (n=37). Based on disease etiology, there were 31 HL-induced AP (HLP) cases and 75 NHL-induced AP (NHLP) cases. The HLP and NHLP groups were compared for parameters of coagulation homeostasis, lipid metabolism, and disease severity. Correlations between disease severity and levels of D-dimer and protein C were investigated, and the prognostic potential of D-dimer was evaluated.
RESULTS: Compared with MAP patients, MSAP patients showed higher levels of D-dimer and lower levels of protein C. HLP patients had higher protein C levels than NHLP patients. Both D-dimer and protein C levels were significantly associated with the disease severity, not the disease etiology. D-dimer levels correlated positively with low density lipoprotein cholesterol levels and performed well as a sensitive and specific predictor of disease severity in AP patients, especially in HLP patients.
CONCLUSIONS: The coagulation homeostasis is different between HLP and NHLP patients, and HL may be a contributing factor for thrombosis and fibrinolysis in HLP. D-dimer may be a robust marker of disease severity in HLP.
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