Serum soluble suppression of tumorigenicity 2 as a novel inflammatory marker predicts the severity of acute pancreatitis

Table 1 Demographic and clinical data of acute pancreatitis patients and health controls

	MAP (n = 55)	MSAP (n = 37)	SAP (n = 31)	Control (n = 42)	χ2/t	P value
Age, yr	45.16 ± 1.74	50.35 ± 2.54	51.94 ± 2.42	45.60 ± 1.75	2.173	0.093
Gender					4.418	0.220
Male	34 (61.8)	21 (56.8)	14 (45.2)	18 (42.9)
Female	21 (38.2)	16 (43.2)	17 (54.8)	24 (57.1)
BMI, kg/m2	25.63 (2.15)	25.81 (1.97)	26.54 (1.22)	24.61 (2.09)	28.518	0.000
Ethnicity					1.7	0.721
Han nationality	52 (94.5)	36 (97.3)	31 (100.0)	41 (97.6)
Minority	3 (5.5)	1 (2.7)	0 (0.0)	1 (2.4)
Etiology					9.374	0.677
Biliary stones	45 (81.8)	27 (73.0)	20 (64.5)
Alcoholic	4 (7.3)	4 (10.8)	3 (9.7)
ERCP	1 (1.8)	0 (0.0)	1 (3.2)
Metabolic	1 (1.8)	1 (2.7)	1 (3.2)
Mixed (alcohol + biliary stones)	2 (3.7)	3 (8.1)	5 (16.2)
Drug-induced idiopathic	1 (1.8)	0 (0.0)	0 (0.0)
Co-morbidity	1 (1.8)	2 (5.4)	1 (3.2)
Hypertension	3 (5.5)	2 (5.4)	2 (6.5)		0.044	0.978
Diabetes	3 (5.5)	3 (8.1)	5 (16.1)		2.691	0.283
Coronary heart disease	3 (5.5)	1 (2.7)	1 (3.2)		0.515	0.860
Cholecystitis	3 (5.5)	1 (2.7)	2 (6.5)		0.582	0.747

Normally distributed continuous variables are represented by the mean ± SE, non-normally distributed continuous variables are represented by the median (interquartile range), and categorical variables are represented by the number of cases and percentages. AP: Acute pancreatitis; BMI: Body mass index; ERCP: Endoscopic retrograde cholangiopancreatography; MAP: Mild acute pancreatitis; MSAP: Moderately severe acute pancreatitis; SAP: Severe acute pancreatitis.

Table 2 Levels of Serum soluble suppression of tumorigenicity 2 and C-reactive protein in different acute pancreatitis groups

	MAP (n = 55)	MSAP (n = 37)	SAP (n = 31)	χ2	P value
	Median (IQR)	Median (IQR)	Median (IQR)
sST2 (pg/mL)	540 (385)	1250 (700)b	1890 (812)b,d	74.899	0.000
CRP 48 h (mg/L)	59.37 (32.92)	76.54 (31.79)b	120.78 (56.66)b,d	59.403	0.000

^bP < 0.001 vs mild acute pancreatitis group.

^dP < 0.001 vs moderately severe acute pancreatitis group. AP: Acute pancreatitis; MAP: Mild AP; MSAP: Moderately severe AP; SAP: Severe AP; sST2: Soluble suppression of tumorigenicity 2; CRP: C- reactive protein.

Table 3 Multivariate binary regressions in acute pancreatitis patients showing association between soluble suppression of tumorigenicity 2 levels on admission and severity, necrosis, organ failure and mortality

Variables	OR (95%CI)	P value	Variables	OR (95%CI)	P value
MAP/MSAP and SAP			Necrosis
Age	1.031 (0.969-1.097)	0.330	Age	1.019 (0.990-1.049)	0.209
BMI	2.629 (1.075-6.429)	0.034	BMI	0.973 (0.695-1.362)	0.847
Gender	1.096 (1.001-1.006)	0.910	Gender	0.529 (0.234-1.198)	0.127
CRP	1.066 (1.031-1.101)	0.002	CRP	1.009 (0.995-1.023)	0.209
sST2	1.003 (1.001-1.006)	0.000	sST2	1.000 (0.999-1.001)	0.837
Any organ failure			Mortality
Age	1.017 (0.963-1.074)	0.546	Age	1.024 (0.967-1.085)	0.411
BMI	1.407 (0.788-2.511)	0.248	BMI	1.685 (0.731-3.883)	0.220
Gender	0.246 (0.050-1.202)	0.083	Gender	0.249 (0.040-1.563)	0.138
CRP	1.030 (0.991-1.071)	0.128	CRP	1.009 (0.987-1.032)	0.415
sST2	1.006 (1.003-1.009)	0.000	sST2	1.002 (1.000-1.004)	0.012

AP: Acute pancreatitis; MAP: Mild AP; MSAP: Moderately severe AP; SAP: Severe AP; BMI: Body mass index; CRP: C-reactive protein; sST2: Soluble suppression of tumorigenicity 2.

Table 4 Correlation between serum inflammatory factor and total hospital stay and intensive care unit stay

sST2/LN (Inflammatory factors, pg/mL)	Total hospital stay		Total ICU stay
	r	P value	r	P value
sST2	0.463b	0.000	0.673b	0.000
LN (IFN-γ)	0.430b	0.000	0.700b	0.000
LN (TNF-α)	0.341b	0.000	0.652b	0.000
LN (IL-2)	-0.043	0.638	-0.082	0.366
LN (IL-4)	-0.483b	0.000	-0.440b	0.000
LN (IL-5)	-0.123	0.174	0.062	0.494
LN (IL-13)	-0.006	0.946	-0.139	0.126

^bP < 0.001. sST2: Soluble suppression of tumorigenicity 2; ICU: Intensive care unit; IFN-γ: Interferon-γ; TNF-α: Tumor necrosis factor-α; IL: Interleukin.

Table 5 Serum inflammatory factor levels in patients with acute pancreatitis

LN (inflammatory factors pg/mL)	MAP, mean ± SE	MSAP, mean ± SE	SAP, mean ± SE	F	P value
LN (IFN-γ)	1.98 ± 0.07	2.57 ± 0.08b	3.08 ± 0.07b	53.393	0.000
LN (TNF-α)	1.63 ± 0.04	2.07 ± 0.05b	2.33 ± 0.05b,d	45.369	0.000
LN (IL-2)	1.06 ± 0.05	1.05 ± 0.06	0.99 ± 0.05	0.362	0.697
LN (IL-4)	1.02 ± 0.03	0.99 ± 0.04	0.64 ± 0.03b,d	23.195	0.000
LN (IL-5)	0.10 ± 0.05	0.10 ± 0.07	0.13 ± 0.08	0.043	0.958
LN (IL-13)	0.76 ± 0.03	0.68 ± 0.06	0.63 ± 0.07	1.703	0.187

Due to the logarithmic transformation of the data, some data are displayed as negative values. The data are expressed as mean ± SE.

^bP < 0.001 vs mild acute pancreatitis group.

^dP < 0.001 vs moderately severe acute pancreatitis group. AP: Acute pancreatitis; MAP: Mild AP; MSAP: Moderately severe AP; SAP: Severe AP; IFN-γ: Interferon-γ; TNF-α: Tumor necrosis factor-α; IL: Interleukin.