Impact of measuring adiponectin ratio for predicting bacterial infection after gastric cancer surgery
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1
Osaka University Graduate School of Medicine, Department of Complementary & Alternative Medicine, Japan
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2
Shiga University of Medical Science, Department of Surgery, Japan
Background
Infections are important causes of postoperative morbidity after gastric surgery; currently, no factors have been identified that can predict postoperative infection. Adiponectin (ADN) mediates energy metabolism and functions as an immunomodulator. Perioperative ADN levels and perioperative immune functioning could be mutually related. Here we evaluated a potential biological marker to reliably predict the incidence of postoperative infections to prevent such comorbidities.
Methods
We analyzed 150 consecutive patients who underwent elective gastric cancer surgery. The patient characteristics and surgery-related factors between two groups (with and without infection) were compared by the paired t-test and χ2 test, including preoperative ADN levels, postoperative day 1ADN levels, and ADN ratio (postoperative AND /preoperative ADN) as baseline factors. Logistic regression analysis was performed to access the independent association between ADN ratio and postoperative infection. Finally, ROCs were constructed to examine its clinical utility.
Results
Sixty patients (40%) experienced postoperative infections. The baseline values of age, physical status, operating time, blood loss, surgical procedure, CRP, preoperative ADN, and ADN ratio were significantly different between groups. Logistic regression analysis indicated that T2DM and ADN ratio were significantly independent variables (p < 0.05, p < 0.01, respectively). ROC analysis revealed that the useful cutoff values (sensitivity/specificity) for preoperative ADN levels, ADN ratio, blood loss, operating time, and CRP levels were 8.81(0.567/0.568), 0.76 (0.767/0.761), 405 g (0.717/0.693), 342 min (0.617/0.614), and 8.94 mg/dl (0.583/0.591), respectively (Figure 1).
Conclusion
T2DM and ADN ratio were independent predictors of postoperative infection and ADN ratio was the most useful predictor for postoperative infection.
Acknowledgements
We sincerely appreciate the cooperation of Ikuko Arikawa, Ryoko Tanaka, Ai Kemmochi from the Department of Surgery, Shiga University of Medical Science (Shiga, Japan), and Yusuke Koga from Department of Complementary & Alternative Medicine, Osaka University Graduate School of Medicine (Osaka, Japan) for accomplishing this research successfully.
Keywords:
Adiponectin,
gastric surgery,
postoperative infections,
perioperative immune,
adiponectin ratio
Conference:
15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013.
Presentation Type:
Abstract
Topic:
Translational immunology and immune intervention
Citation:
Maeda
K and
Yamamoto
H
(2013). Impact of measuring adiponectin ratio for predicting bacterial infection after gastric cancer surgery.
Front. Immunol.
Conference Abstract:
15th International Congress of Immunology (ICI).
doi: 10.3389/conf.fimmu.2013.02.01061
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Received:
30 Jun 2013;
Published Online:
22 Aug 2013.
*
Correspondence:
Dr. Kazuhisa Maeda, Osaka University Graduate School of Medicine, Department of Complementary & Alternative Medicine, Suita, Osaka, 5650871, Japan, maedakazu@aol.com