Vitamin D and iron levels correlate weakly with hepcidin levels in postoperative patients with digestive neoplasms undergoing open abdominal surgery.

OBJECTIVE: Patients with digestive neoplasms have both iron deficiency and chronic inflammatory anemia with hepcidin upregulation, which may be aggravated in the postoperative period. Vitamin D impacts hepcidin levels. We aimed to investigate the correlations between vitamin D and iron status vs. hepcidin levels in patients with digestive tumors undergoing open abdominal surgery. PATIENTS AND METHODS: This prospective observational study was performed during 2016-2018 in a University teaching hospital. After obtaining the Ethical Approval and the patients' informed consent, 30 adult patients with digestive tumors were included. Hepcidin, vitamin D and iron levels were measured in the first 24 hours after surgery. RESULTS: We observed a negligible/weak correlation between serum iron and hepcidin levels in the first 24 hours after surgery, with a correlation coefficient of 0.24 and a weak/low correlation between hepcidin and vitamin D levels, with a correlation coefficient of 0.37. CONCLUSIONS: The correlations between vitamin D and hepcidin levels, as well as between hepcidin and serum iron levels, are weak. Interindividual variability in iron-hepcidin-vitamin D regulation might be wide and other regulatory mechanisms might also play important roles in inflammatory anemia modulation in the perioperative period.

sTREM-1, sIL-2Rα, and IL-6, but not sCD163, might predict sepsis in polytrauma patients: a prospective cohort study.

BACKGROUND: To investigate whether sTREM-1, sIL-2Rα, sCD163, and IL-6 predict septic complications following polytrauma. Prospective observational study in a university hospital intensive care unit. METHODS: Blood samples were drawn on admission, 24 and 48 h after the injury from 64 adult polytrauma patients. The occurence of infectious complications was investigated. The sepsis-free rates for the multiple trauma patients were considered as end points in the Kaplan-Meier plot analysis. RESULTS: Upon admission, sIL-2Rα mean values were higher in the T group compared to the T&S patients (1789 ± 1027 pg/mL versus 1280 ± 605 pg/mL, p = 0.02). The initial mean values of sTREM-1, IL-6, and sCD163 did not discriminate between the T and T&S groups patients (p > 0.05). sTREM-1 cutoff was 62 pg/mL: the sepsis-free rates differed significantly between the patients with sTREM-1 concentrations lower and higher than the cutoff (80 versus 48 %, p < 0.01). From the patients with serum sIL-2Rα ≥1593 pg/mL, 86 % did not present sepsis; for sIL-2Rα values in the range 946-1593 pg/mL, the sepsis-free rate was 68 %, while from the patients with sIL-2Rα <945 pg/mL, only 40 % remained sepsis-free (p = 0.05). sCD163 cutoff of 1000 ng/mL did not discriminate between the patients (76 versus 64 %, p = 0.28). For IL-6, the sepsis-free rates differed significantly between the patients with concentrations lower and higher than 400 pg/mL (78 versus 38 %, p < 0.01). CONCLUSIONS: sTREM-1, sIL-2Rα, and IL-6, but not CD163, may be used as prognostic markers for the occurrence of sepsis in multiple trauma patients. LEVEL OF EVIDENCE: Level II-Diagnostic tests and criteria.