ABSTRACT
BACKGROUND: The systemic response of the organism, in defense against the aggressor agent, generates acute catabolic response, which leads to deterioration of the nutritional status. OBJECTIVE: Compare the usefulness of the body mass index (BMI) and the CONUT scale to determine the severity in abdominal sepsis. METHODS: Retrospective, descriptive, cross-sectional study in patients with diagnosis of abdominal sepsis, from April 2016 to February 2017. RESULTS: We included 153 cases (61 female and 92 male); mean age of 47.44 years, the main organ causing abdominal sepsis was the appendix 43%. Mortality of 15%. An average BMI of 27.31, CONUT score of 5.5, was obtained. The findings, subjected to the Mann-Whitney u test, showed statistical significance when evaluating BMI against SOFA (p = 0.025); no significance was found when evaluating the BMI against APACHE II (p = 0.322), nor against mortality (p = 0.646). Regarding CONUT, significance was found when comparing against APACHE II, SOFA and mortality (p = 0.002, p = 0.001 and p = 0.007, respectively). CONCLUSIONS: The level of malnutrition determined by CONUT is related to the severity determined by APACHE II, SOFA and mortality. BMI is not related to severity by APACHE II or mortality; although it does seem to relate to the severity evaluated by the SOFA scale.
INTRODUCCIÓN: La respuesta sistémica del organismo, en defensa ante el agente agresor, genera una respuesta catabólica aguda que conduce a deterioro del estado nutricional. OBJETIVO: Comparar la utilidad del índice de masa corporal (IMC) y del índice de Control Nutricional (CONUT) para determinar la gravedad en pacientes con sepsis abdominal. MÉTODO: Estudio retrospectivo, descriptivo, transversal, en pacientes con diagnóstico de sepsis abdominal, de abril de 2016 a febrero de 2017. RESULTADOS: Se incluyeron 153 casos (61 mujeres y 92 hombres). El principal órgano causante de sepsis abdominal fue el apéndice (43%). La mortalidad fue del 15%. El IMC promedio fue de 27.31. El CONUT promedio fue de 5.5, Los hallazgos, sometidos a la prueba U de Mann-Whitney, mostraron al evaluar el IMC contra la escala SOFA (Sequential Organ Failure Assessment Score) una p = 0.025; no se encontró significancia al evaluar el IMC contra APACHE II (Acute Physiology and Chronic Health Evaluation) (p = 0.322) ni contra la mortalidad (p = 0.646). En cuanto a CONUT, se encontró significancia al compararla contra APACHE II, SOFA y la mortalidad (p = 0.002, p = 0.001 y p = 0.007, respectivamente). CONCLUSIÓN: El grado de malnutrición determinado por CONUT se relaciona con la gravedad determinada mediante APACHE II y SOFA, y con la mortalidad. El IMC no se relaciona con la gravedad por APACHE II ni con la mortalidad, aunque sí parece relacionarse con la gravedad evaluada mediante SOFA.
Subject(s)
Body Mass Index , Nutritional Status , Sepsis/diagnosis , APACHE , Abdomen , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Interleukin 15 (IL-15) is a Th1-related cytokine that triggers inflammatory cell recruitment with implications for pathogenesis in ulcerative colitis. The IL-15 gene is located within a 35 kb region of the q28-31 locus of chromosome 4. In the present work, the role of IL-15 gene polymorphisms as susceptibility markers for UC was evaluated. Seven polymorphisms of IL-15 (rs3806798, rs10833, rs4956403, rs2254514, rs2857261, rs10519613, and rs1057972) were genotyped by 5' exonuclease TaqMan genotyping assays in a group of 199 Mexican patients with UC and 698 Mexican Mestizo healthy unrelated individuals. UC patients and healthy controls showed similar distribution of the rs3806798, rs10833, rs4956403, rs2857261, rs10519613, and rs1057972 polymorphisms. The rs2254514 polymorphism was significantly associated with decreased risk of UC as compared to controls under both dominant and additive models (OR 0.62, Pdom = 0.014 and OR 0.65, Padd = 0.02). The rs2254514 CC genotype was associated with young age at diagnosis <40 years (P = 0.03; OR 3.67). Five polymorphisms (rs1051613, rs2254514, rs2857261, rs1057972, and rs10833) were in strong linkage disequilibrium and were included in six haplotypes: H1 (ACAAC), H2 (CCGTC), H3 (CTAAT), H4 (CCAAT), H5 (CTAAC), and H6 (CCAAC). UC patients showed an increased frequency of the H6 haplotype (P = 0.005; OR 3.2) and a decreased frequency of the H5 haplotype (P = 0.031; OR 0.40). These results suggest that the IL-15 rs2254514 polymorphism might have an important role in the development of UC in the Mexican population. We were able to distinguish one risk and one protective uncommon haplotype for the development of UC.
Subject(s)
Colitis, Ulcerative/genetics , Genetic Predisposition to Disease , Interleukin-15/genetics , Polymorphism, Single Nucleotide , Adult , Aged , Alleles , Case-Control Studies , Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/drug therapy , Female , Gene Frequency , Genetic Association Studies , Haplotypes , Humans , Linkage Disequilibrium , Male , Mexico , Middle Aged , Odds Ratio , Risk , Young AdultABSTRACT
Interleukin (IL)-20 belongs to the IL-10 family and is a potent immunomodulatory cytokine with implications for pathogenesis in the inflammatory bowel disease (IBD). The interleukin 20 gene is located within a 200kb region of q31-32 locus of chromosome 1. No previous studies have reported this novel association between ulcerative colitis (UC) and IL-20 polymorphisms. In the present work, we evaluated the role of IL-20 gene polymorphisms as susceptibility markers for UC. Three polymorphisms of IL-20 gene (rs2981573, rs2232360, rs1518108) were genotyped by 5' exonuclease TaqMan genotyping assays on an ABI Prism 7900 HT Fast Real-Time PCR system in a group of 198 Mexican Mestizo patients with UC and 698 ethnically matched healthy unrelated individuals with no family history of UC. We found significant decreased frequencies of two IL-20 genotypes: GG (rs2981573) [10.6% vs. 17.6%, p=0.017, OR=0.55, 95% CI: 0.33-0.93] and GG (rs2232360) [10.6% vs. 17.6%, p=0.017, OR=0.55, 95% CI: 0.33-0.93] in UC patients as compared to healthy controls. No significant differences of gene frequencies were found between UC patients and healthy controls in the rs1518108 polymorphism. In the subgroup analysis, no differences were found between the IL-20 genotypes and the clinical characteristics of UC. The results suggest that the GG genotypes of the IL-20 polymorphisms (rs2981573 and rs2232360) might have an important role in the development of UC in the Mexican population.
