Changes in preoperative and postoperative lipoprotein-associated phospholipase A2 activity in patients with malignant
Ying Zhao1, Guofang Feng2, Limin Feng3
1Department of Laboratory Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, China.
Background:
Malignant obstructive jaundice (MOJ) leads to hyperbilirubinemia and systemic pathophysiological changes. The main clinical treatments for MOJ include radical pancreatoduodenectomy, palliative surgical treatment, and minimally invasive treatment, which can relieve biliary obstruction, drain bile, reduce jaundice, and improve liver function. In rat models, hepatic exposure to endotoxin resulted in rapid increases in biliary and plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) levels, and our previous study revealed that Lp-PLA2 activity was strongly associated with liver damage. The present study aimed to clarify the serum Lp-PLA2 activity changes and evaluate the associations between Lp-PLA2 activity and laboratory parameters in MOJ patients preoperatively and postoperatively.
Methods:
Twenty-one patients with MOJ were enrolled in this prospective study. Lp-PLA2 activity and other laboratory parameters were analyzed using a Hitachi 7600 automatic biochemical analyzer. Spearman correlation coefficients, percent differences, and dynamic difference plots were used to evaluate the changes in preoperative and postoperative Lp-PLA2 activity and the associations of Lp-PLA2 activity with other laboratory parameters.
Results:
The postoperative Lp-PLA2 activity at 1 day [646 (range, 175-1,025) U/L], 1 week [419 (range, 144-949) U/L], and day of hospital discharge [347 (range, 165-698) U/L] differed significantly from the preoperative baseline activity (636 (range, 172-1,664) U/L; P<0.05 for all). Lp-PLA2 activity was correlated with total bilirubin (TB) at specific time points (P<0.05 for all). The percent differences and dynamic difference graphs revealed that Lp-PLA2 activity, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and TB gradually decreased after biliary obstruction was relieved by surgical treatment.
Conclusions:
Lp-PLA2 activity in MOJ patients was associated with biliary obstruction and liver damage. Serum Lp-PLA2 can be used as a novel indicator for biliary obstruction severity and treatment monitoring.
Related Concept Videos
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:25Blood Studies for Cardiovascular System III: Serum Lipid Profile
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...