scholarly journals Elevated Plasma Neutrophil Gelatinase-Associated Lipocalin Level as a Risk Factor for Anemia in Patients with Systemic Inflammation

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Jong Weon Choi ◽  
Tatsuyoshi Fujii ◽  
Noriyoshi Fujii
Keyword(s):  
Systemic Inflammation ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Regulatory Protein ◽  
Multivariate Logistic Regression Analysis ◽  
High Sensitivity ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Reactive Protein ◽  
Plasma Ngal ◽  
Neutrophil Gelatinase

Studies on neutrophil gelatinase-associated lipocalin (NGAL) as an iron-regulatory protein are limited. This study investigated the relationships between plasma NGAL levels and indices of anemia in 187 patients with systemic inflammation. Plasma NGAL levels were significantly higher in patients with anemia versus in patients without anemia (185 ng/mL versus 98 ng/mL; P < 0.001). Serum iron levels were lower in patients with NGAL > 156 ng/mL than in those with NGAL ≤ 156 ng/mL (27.4 ± 25.3 µg/dL versus 58.1 ± 43.5 µg/dL; P < 0.001). In a receiver operating characteristic curve, the diagnostic ability of NGAL to identify anemia was superior to that of high-sensitivity C-reactive protein [0.712 (95% CI, 0.618–0.787) versus 0.649 (95% CI, 0.573–0.744); P < 0.01]. In a multivariate logistic regression analysis, the elevated NGAL level was significantly associated with the presence of anemia after adjusting for potential confounders [odds ratio, 1.30 (95% CI, 1.07–2.58); P = 0.010]. In conclusion, enhanced NGAL production may contribute to the development of anemia in patients with systemic inflammation.

scholarly journals Relationship between serum angiopoietin-like 4 levels and recurrence of atrial fibrillation

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098839
Author(s):  
Zhongping Ning ◽  
Xinming Li ◽  
Xi Zhu ◽  
Jun Luo ◽  
Yingbiao Wu
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
High Sensitivity ◽  
Peroxisome Proliferator ◽  
C Reactive Protein ◽  
Peroxisome Proliferator Activated Receptor ◽  
Reactive Protein ◽  
New Onset

Objective To investigate the association between serum angiopoietin-like 4 (ANGPTL4) levels and recurrence of atrial fibrillation (AF) after catheter ablation. Methods This retrospective study recruited patients with AF undergoing catheter ablation and they were divided into two groups (new-onset AF group and recurrent AF group). Demographic, clinical, and laboratory parameters were collected. Results A total of 192 patients with AF were included, including 69 patients with recurrence of AF. Serum ANGPTL4 levels were lower in patients with recurrent AF than in those with new-onset AF. Serum ANGPTL4 levels were positively correlated with superoxide dismutase and peroxisome proliferator-activated receptor γ, and negatively correlated with the CHA2DS2-VASC score, left atrial diameter, and levels of brain natriuretic peptide, malondialdehyde, high-sensitivity C-reactive protein, and interleukin-6. The receiver operating characteristic curve showed that the best cut-off for recurrent AF was serum ANGPTL4 levels  < 19.735 ng/mL, with a sensitivity and specificity of 63.9% and 74.5%, respectively. Serum ANGPTL4 levels were significantly associated with recurrence and new onset of AF (odds ratio, 2.241; 95% confidence interval, 1.081–4.648). Conclusions Serum ANGPTL4 levels are lower in patients with recurrent AF than in those with new-onset AF, and are associated with cardiac hypertrophy, oxidative stress, and inflammation.

scholarly journals Significance of Neutrophil Gelatinase-Associated Lipocalin Level-to-Serum Creatinine Ratio for Assessing Severity of Inflammation in Patients with Renal Dysfunction

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Jong Weon Choi ◽  
Tatsuyoshi Fujii ◽  
Noriyoshi Fujii
Keyword(s):  
Serum Creatinine ◽  
Renal Dysfunction ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Creatinine Ratio ◽  
Ngal Level ◽  
Operating Characteristics ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Plasma Ngal ◽  
Neutrophil Gelatinase

The aim of this study was to assess the significance of the neutrophil gelatinase-associated lipocalin/serum creatinine ratio (NGAL/sCr ratio) in patients with renal dysfunction. The percent difference between plasma NGAL level and the NGAL/sCr ratio was 36.7% (95% CI, 18.4–83.7%) in patients with sCr level ≥ 1.2 mg/dL. In a multivariate analysis, high sensitivity C-reactive protein (hsCRP) was significantly associated with the NGAL/sCr ratio and plasma NGAL level (r=0.526andr=0.453, resp.,P<0.001). In a receiver operating characteristics curve, the diagnostic ability of the NGAL/sCr ratio to identify hsCRP > 4.0 mg/dL was superior to that of NGAL [0.783 (95% CI, 0.674–0.892) versus 0.733 (95% CI, 0.615–0.852),P=0.032]. The area under the curve of the NGAL/sCr ratio was larger than that of hsCRP to detect corrected erythrocyte sedimentation rate > 25 mm/h and the neutrophil-to-lymphocyte ratio >4.5 in renal dysfunction. In short, the NGAL/sCr ratio may offer useful information when screening patients with both systemic inflammation and renal dysfunction.

scholarly journals The association between high-sensitivity C-reactive protein at admission and progressive motor deficits in patients with penetrating artery infarctions

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Pengyu Gong ◽  
Yukai Liu ◽  
Ting Huang ◽  
Wenxiu Chen ◽  
Teng Jiang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Characteristic Curve ◽  
Multivariate Logistic Regression Analysis ◽  
High Sensitivity ◽  
Motor Deficit ◽  
Motor Deficits ◽  
C Reactive Protein ◽  
Discriminative Ability ◽  
Reactive Protein ◽  
Hs Crp

Abstract Background A fraction of patients with penetrating artery infarction (PAI) experience progressive motor deficit deterioration (PMD). We sought to investigate the role of high-sensitivity C-reactive protein (hs-CRP) at admission in predicting PMD. Methods From January 2015 to September 2018, consecutive patients with PAI from three centers were prospectively enrolled in this study. PMD was defined as worsening of motor function score by ≥1 point on the National Institutes of Health Stroke Scale during the first 5 days after admission. Multivariable logistic regression analyses were performed to explore the relationship between hs-CRP and PMD in patients with PAI. We also performed receiver operating characteristic curve analysis and constructed a nomogram to assess the overall discriminative ability of hs-CRP in predicting PMD. Results We ultimately included 544 patients (mean age, 65.4 ± 11.8 years). A total of 85 (15.6%) patients were identified to have PMD. Multivariate logistic regression analysis showed that hs-CRP was independently associated with PMD (P = 0.001). The optimal cutoff value for hs-CRP as a predictor for PMD was 3.48 mg/L, with a sensitivity of 73.64% and a specificity of 82.35% (area under curve, 0.792). Moreover, the nomogram we constructed indicated that higher level of hs-CRP was an indicator of PMD (c-index = 0.780, P < 0.001). Conclusions Our study suggested that hs-CRP might be a useful biomarker for predicting the risk of PMD in patients with PAI.

scholarly journals Procalcitonin, C-reactive protein, neutrophil gelatinase-associated lipocalin, resistin and the APTT waveform for the early diagnosis of serious bacterial infection and prediction of outcome in critically ill children

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246027
Author(s):  
Maryke J. Nielsen ◽  
Paul Baines ◽  
Rebecca Jennings ◽  
Sarah Siner ◽  
Ruwanthi Kolamunnage-Dona ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Critically Ill Children ◽  
Correct Classification ◽  
C Reactive Protein ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Reactive Protein ◽  
Plasma Ngal ◽  
Net Reclassification Improvement ◽  
Neutrophil Gelatinase

Objective Bacterial Infections remains a leading cause of death in the Paediatric Intensive Care Unit (PICU). In this era of rising antimicrobial resistance, new tools are needed to guide antimicrobial use. The aim of this study was to investigate the accuracy of procalcitonin (PCT), neutrophil gelatinase-associated lipocalin (NGAL), resistin, activated partial thromboplastin time (aPTT) waveform and C-reactive protein (CRP) for the diagnosis of serious bacterial infection (SBI) in children on admission to PICU and their use as prognostic indicators. Setting A regional PICU in the United Kingdom. Patients Consecutive PICU admissions between October 2010 and June 2012. Measurements Blood samples were collected daily for biomarker measurement. The primary outcome measure was performance of study biomarkers for diagnosis of SBI on admission to PICU based on clinical, radiological and microbiological criteria. Secondary outcomes included durations of PICU stay and invasive ventilation and 28-day mortality. Patients were followed up to day 28 post-admission. Main results A total of 657 patients were included in the study. 92 patients (14%) fulfilled criteria for SBI. 28-day mortality was 2.6% (17/657), but 8.7% (8/92) for patients with SBI. The combination of PCT, resistin, plasma NGAL and CRP resulted in the greatest net reclassification improvement compared to CRP alone (0.69, p<0.005) with 10.5% reduction in correct classification of patients with SBI (p 0.52) but a 78% improvement in correct classification of patients without events (p <0.005). A statistical model of prolonged duration of PICU stay found log-transformed maximum values of biomarkers performed better than first recorded biomarkers. The final model included maximum values of CRP, plasma NGAL, lymphocyte and platelet count (AUC 79%, 95% CI 73.7% to 84.2%). Longitudinal profiles of biomarkers showed PCT levels to decrease most rapidly following admission SBI. Conclusion Combinations of biomarkers, including PCT, may improve accurate and timely identification of SBI on admission to PICU.

scholarly journals A novel biomarker in the diagnosis of parapneumonic effusion: neutrophil gelatinase-associated lipocalin

2014 ◽  
Vol 9 ◽  
Author(s):  
Aziz Gümüs ◽  
Sevket Ozkaya ◽  
Songul Ozyurt ◽  
Halit Cınarka ◽  
Aynur Kirbas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pleural Effusion ◽  
Inflammatory Diseases ◽  
High Sensitivity ◽  
High Serum ◽  
Parapneumonic Effusion ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Reactive Protein ◽  
Common Causes ◽  
Neutrophil Gelatinase

Background: The protein neutrophil gelatinase-associated lipocalin (NGAL) is a mediator synthesized and released by neutrophils. Its physiological function is as yet unclear. Levels in blood increase in several inflammatory diseases. High serum values indicate poor prognosis for several diseases. Pleural effusion may appear as the result of various pathologies. The most common cause is heart failure (HF). Other common causes include parapneumonic (PPE) and malignant (MPE) pleural effusions, and pulmonary embolism. Tubercular effusion (TE) is commonly encountered in Turkey and similar developing countries. The purpose of this study was to investigate the effectiveness of NGAL, a current inflammation marker, in discriminating between different etiological diseases that cause pleural effusion. Methods: The study was performed at the Recep Tayyip Erdoğan University Faculty of Medicine Chest Diseases Clinic. One hundred patients were included in the study, 25 with parapneumonic effusion, 25 with heart failure-related effusion, 25 with tubercular effusion and 25 with cancer-related effusion. NGAL was measured in patients’ serum and pleural fluids. Results: Serum NGAL levels in PPE (171 ± 56 ng/ml) were significantly higher (p < 0.001) than those in HF (86 ±31 ng/ml), CA (103 ± 42 ng/ml) and TE (63 ± 19 ng/ml). Pleural NGAL levels were also significantly higher in PPE compared to HF, MPE and TE (p < 0.001). Serum NGAL levels exhibited a positive correlation with white blood cell (WBC), neutrophil, C-reactive protein (CRP), sedimentation, serum LDH, creatinine, pleural leukocyte and pleural neutrophil numbers. The most significant correlation was between NGAL level and WBC (p < 0.001, r = 0.579). Both serum and pleural NGAL levels are highly effective in differentiating patients with PPE from those without PPE (AUC: 0.910 and 0.790, respectively). Conclusions: NGAL can be used in the diagnosis of diseases with an acute inflammatory course. Serum and pleural NGAL levels can differentiate PPE from other diseases causing pleural fluid with high sensitivity and specificity.

scholarly journals Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ser Hon Puah ◽  
◽  
Barnaby Edward Young ◽  
Po Ying Chia ◽  
Vui Kian Ho ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Features ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Case Series ◽  
Plateau Pressure ◽  
Apache Ii Score ◽  
Multivariable Logistic Regression Model ◽  
Reactive Protein ◽  
Ventilatory Management

AbstractWe aim to describe a case series of critically and non-critically ill COVID-19 patients in Singapore. This was a multicentered prospective study with clinical and laboratory details. Details for fifty uncomplicated COVID-19 patients and ten who required mechanical ventilation were collected. We compared clinical features between the groups, assessed predictors of intubation, and described ventilatory management in ICU patients. Ventilated patients were significantly older, reported more dyspnea, had elevated C-reactive protein and lactate dehydrogenase. A multivariable logistic regression model identified respiratory rate (aOR 2.83, 95% CI 1.24–6.47) and neutrophil count (aOR 2.39, 95% CI 1.34–4.26) on admission as independent predictors of intubation with area under receiver operating characteristic curve of 0.928 (95% CI 0.828–0.979). Median APACHE II score was 19 (IQR 17–22) and PaO2/FiO2 ratio before intubation was 104 (IQR 89–129). Median peak FiO2 was 0.75 (IQR 0.6–1.0), positive end-expiratory pressure 12 (IQR 10–14) and plateau pressure 22 (IQR 18–26) in the first 24 h of ventilation. Median duration of ventilation was 6.5 days (IQR 5.5–13). There were no fatalities. Most COVID-19 patients in Singapore who required mechanical ventilation because of ARDS were extubated with no mortality.

scholarly journals Neutrophil gelatinase–associated lipocalin as a biomarker of nephropathy in sickle cell disease

2021 ◽  
Author(s):  
Rajaa Marouf ◽  
Adekunle D. Adekile ◽  
Hadeel El-Muzaini ◽  
Rasha Abdulla ◽  
Olusegun A. Mojiminiyi
Keyword(s):  
Steady State ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Roc Curve ◽  
Screening Tests ◽  
Cell Disease ◽  
Urine Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Plasma Ngal ◽  
Neutrophil Gelatinase

AbstractSickle cell nephropathy (SCN) develops via altered hemodynamics and acute kidney injury, but conventional screening tests remain normal until advanced stages. Early diagnostic biomarkers are needed so that preventive measures can be taken. This study evaluates the role of neutrophil gelatinase–associated lipocalin (NGAL) as a biomarker of SCN in steady state and vaso-occlusive crisis (VOC). In this case-control study, 74 sickle cell disease (SCD) patients (37 in steady state and 37 in VOC) and 53 control subjects had hematological and biochemical measurements including plasma and urine NGAL. Univariate and logistic regression analyses were used to find the associations between variables. The receiver operating characteristic (ROC) curve was used to determine the diagnostic performance characteristics of plasma and urine NGAL for detection of VOC. Plasma and urine NGAL, urine microalbumin:creatinine ratio, and urine protein:creatinine ratio were significantly higher in VOC. Microalbuminuria was present in 17.1% steady state and 32.0% VOC patients. Microalbuminuria showed significant correlations with age, plasma NGAL, WBC, and hemolytic parameters. Area under the ROC curve for plasma NGAL was 0.69 (95%CI = 0.567–0.813; p = 0.006) and 0.86 (95%CI = 0.756–0.954; p < 0.001) for urine NGAL. Urine NGAL cut-off value of 12.0 ng/mL had 95% sensitivity and 65% specificity. These results confirm the presence of nephropathy during VOC and suggest that plasma and urine NGAL would be useful in the identification of SCN. Urine NGAL should be used as the screening biomarker, and patients with VOC and urine NGAL > 12.0 ng/mL should be selected for aggressive management to prevent progression of renal damage.

scholarly journals Neutrophil gelatinase-associated lipocalin as a biomarker for acute kidney injury in children after cardiac surgery

2016 ◽  
Vol 56 (4) ◽  
pp. 230
Author(s):  
Meta Herdiana Hanindita ◽  
Riskky Vitria Prasetyo ◽  
Ninik Asmaningsih Soemyarso ◽  
I Ketut Alit Utamayasa ◽  
Paul Tahalele
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Creatinine Clearance ◽  
Sensitivity And Specificity ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Schwartz Formula ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Plasma Ngal ◽  
Neutrophil Gelatinase

Background Acute kidney injury (AKI) is still diagnosed by measuring the estimated creatinine clearance (eCCl), despite the fact that it may not change until 50% or more of kidney function has been lost. AKI after cardiac surgery is related to prolonged intensive care, decreased quality of life, and increased long term mortality. Neutrophil gelatinase-associated lipocalin (NGAL) represents an early biomarker of AKI, which may be useful for assessing AKI in cardiac patients.Objective To determine the validity of urinary and plasma NGAL as biomarkers for AKI in children after cardiac surgery.Methods Subjects were children who underwent cardiac surgery in Dr. Soetomo Hospital, Surabaya, Indonesia from August 2013 to January 2014. Serial urine and blood samples were analyzed for NGAL before surgery, as well as at 2h, 4h, 12h, and 24h after surgery. The AKI was established based on pRIFLE criteria. Estimated creatinine clearance (eCCl) was calculated from the estimated glomerular filtration rate (eGFR), according to age by the traditional Schwartz formula. Serum creatinine was assayed by the Jaffe method before surgery, as well as at 12h, 24h, 48h, and 72h after surgery.Results Of 20 subjects, 5 developed AKI. Urinary and plasma NGAL increased markedly at 2h postoperatively, as compared to eGFR which showed a rise at 12-48 h after cardiac surgery. Analysis of 2h post-operative urinary NGAL at a cut off value of 11.270ng/mL yielded an area under the curve (AUC) of 1.00 (95%CI 2.63 to 12.13), with sensitivity and specificity of 100% each for AKI. In addition, 2h post-operative plasma NGAL at a cut off value of 8.385 ng/mL yielded an AUC of 1.00 (95%CI 3.71 to 12.15) with sensitivity and specificity of 100% each for AKI.Conclusion Urinary and plasma NGAL are valid as early biomarkers for AKI in children after cardiac surgery.

Neutrophil gelatinase-associated lipocalin as a potential biomarker for pulmonary thromboembolism

2019 ◽  
Vol 45 (1) ◽  
pp. 51-56
Author(s):  
Songul Ozyurt ◽  
Mevlut Karatas ◽  
Medeni Arpa ◽  
Bilge Yilmaz Kara ◽  
Hakan Duman ◽  
...  
Keyword(s):  
Predictive Value ◽  
Pulmonary Thromboembolism ◽  
High Sensitivity ◽  
Control Group ◽  
Arterial Blood Gas ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Arterial Blood ◽  
Potential Biomarker ◽  
Healthy Control ◽  
Neutrophil Gelatinase

Abstract Objective Pulmonary thromboembolism (PTE) is a clinical condition that can be lethal unless promptly diagnosed and treated. The objective was to evaluate the significance of serum neutrophil gelatinase-associated lipocalin (NGAL) in the diagnosis of PTE. Materials and methods In this study, 60 patients hospitalized for acute PTE between May 2015 and December 2016 were enrolled. PTE was diagnosed using spiral computed tomography angiography of the thorax. Cardiac enzyme levels, arterial blood gas, and echocardiography measurements were performed. Whole blood samples were drawn to measure serum NGAL before treatment. Results The PTE group comprised 34 women and 26 men, and the healthy control group included 22 women and 18 men. The mean ages of the patient and control groups were 70.3 ± 14.4 years and 69.0 ± 10.2 years, respectively. Serum NGAL was significantly higher in the patients than in the controls (88.6 ± 33.6 vs. 31.7 ± 10.0 ng/mL, p < 0.001, respectively). The optimal NGAL cut-off value was >50 ng/mL, the sensitivity was 100%, specificity was 98.3%, the negative predictive value was 100%, and the positive predictive value was 68%. Conclusion Serum NGAL is a new biomarker with high sensitivity and specificity to detect, diagnose, and exclude PTE.

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