Expression Of Chemerin In Serum Of Patients With Fatty Pancreas And Its Clinical Predictive Value

Objective:To study the expression level of Chemerin and other adipokines(leptin,adiponectin,resistin,tumor necrosis factor-α(TNF-α)in serum of patients with fatty pancreas and its clinical predictive value in patients prone to fatty pancreas,as well as to search for risk factors related to fatty pancreas.Method:A total of 130 fatty pancreas patients and 18 healthy people(without common metabolic diseases)who underwent physical examination at the Health Physical Examination Center of the Affiliated Hospital of Yangzhou University from October 2018 to June 2019 were included in this study.According to the diagnosis of whether or not the people has fatty pancreas by color ultrasound,the subjects is divided into fatty pancreas(FP)group(a total of 130 people)and normal controls(NC)group(a total of 18 people).Among them,the subjects of fatty pancreas group is divided into four groups according to whether there is combined with the following three kinds of metabolic diseases(fatty liver,diabetes,obesity):pure fatty pancreas(PFP)group(n=55);fatty pancreas with fatty liver(FL)group(FP+FL,n=25);fatty pancreas with obesity(OB)group(FP+OB,n=25);fatty pancreas with diabetes mellitus(DM)group(FP+DM,n=25).The basic information of patients(height,weight,BMI,abdominal circumference,gender)and previous history(smoking,drinking,hypertension,fatty liver)were collected.Biochemical indexes such as blood routine,liver and kidney function,and lipid composition were detected.Serological levels of Chemerin and other adipokines(leptin,adiponectin,resistin,tumor necrosis factor-a)were determined by enzyme linked immunosorbent assay(ELISA),and the correlation between serological indexes and fatty pancreas was analyzed by reasonable statistical methods.Results:1.Analysis of general clinical data between fatty pancreas patients and healthy control group:the average body mass index and abdominal circumference of fatty pancreas patients were significantly higher than those of normal control group(P<0.001).The levels of blood cholesterol,glutamyl transpeptidase,blood glucose and triglyceride in fatty pancreas patients were significantly higher than those in normal control group(all P<0.05),while the levels of high-density lipoprotein cholesterol in fatty pancreas patients were significantly lower than those in normal control group(P<0.001).2.The expression of Chemerin and other adipocytokines in fatty pancreas patients:the serum expressions of Chemerin,leptin,TNF-α,Chemerin/HDL-C,and Chemerin/adiponectin in fatty pancreas patients were significantly higher than those in normal control group(all P<0.05),while adiponectin was the opposite(P=0.024).There was no significant difference in the expression level of resistin between patients with fatty pancreas and normal control group.3.Analysis of general clinical data between healthy control group and fatty pancreas subgroups:there were significant differences in BMI,abdominal circumference,hypertension,diabetes mellitus,fatty liver and obesity between normal group and fatty pancreas subgroups,with P<0.05.However,there were no significant differences in sex,smoking history and drinking history between the normal group and the fatty pancreas group.Un the analysis of general biochemical data,ALT,GGT,CHO,HDL-C,TG and GLU showed statistically significant differences among groups(P<0.05).①ALT:ALT level in PFP group was significantly lower than that in FP+OB group,and the difference had statistically significant(P=0.038).②GGT:GGT level in NC group was significantly lower than FP+OB,and the difference was statistically significant(P=0.001).③CHO:The level of CHO in NC group was significantly lower than that in FP+MD group,and the difference had statistically significant(P=0.023).④TG:TG level in NC group was significantly lower than that in FP+FL group,and the difference had statistically significant(P=0.008).⑤GLU:GLU level in NC group was significantly lower than that in FP+OB and FP+MD groups,and the differences were statistically significant(P<0.05).There were significant statistical differences between FP+FL group and FP+MD group,between PFP group and FP+MD group,between FP+OB group and FP+MD group(P<0.05).⑥HDL-C:The level of HDL-C in NC group was significantly higher than that in fatty pancreas subgroups,and the differences had statistically significant(P<0.05).4.Analysis of serum Chemerin and other adipokines in healthy control group and fatty pancreas subgroups:①Leptin,The serum leptin level of the normal group was significantly lower than that of the pure fatty pancreas group and fatty pancreas combined with obesity group,and the differences had statistically significant(P<0.05).There was significant difference in serum leptin level between the pure fatty pancreas group and the fatty pancreas group combined with fatty liver(P=0.044).②Adiponectin:The level of serum adiponectin in the normal group was significantly higher than that in the fatty pancreas combined with obesity group and the fatty pancreas combined with diabetes group,and the differences were statistically significant(P<0.05).The level of serum adiponectin in fatty pancreas combined with diabetes mellitus was significantly lower than that in pure fatty pancreas group and fatty pancreas combined with fatty liver group,and the differences were statistically significant(P<0.05).The difference of serum adiponectin level between the fatty pancreas group combined with fatty liver and the fatty pancreas group combined with obesity was also statistically significant.③TNF-α:The serum TNF-α level in the normal group was significantly lower than that in the pure fatty pancreas group and fatty pancreas combined with diabetes mellitus group,and the differences were statistically significant(P<0.05).④Chemerin:Serum Chemerin levels in normal group were lower than all of those in fatty pancreas subgroups,and the differences were statistically significant(P<0.05).⑤Chemerin/HDL-C:Serum Chemerin/HDL-C levels in normal group were lower than those in fatty pancreas subgroups,and the differences were statistically significant(P<0.05).⑥Chemerin/adiponectin:The level of serum Chemerin/adiponectin in normal group was significantly lower than that in pure fatty pancreas group,fatty pancreas combined with obesity group and fatty pancreas combined with diabetes group,and the differences were statistically significant(P<0.05).⑦Resistin:There was no significant difference in serum resistin levels between the normal group and the fatty pancreas subgroups,with all P>0.05.5.Pearson correlation analysis showed that serum Chemerin level was negatively correlated with adiponectin(r=-0.184,P=0.025).6.Univariate Logistic regression analysis showed that Chemerin(P<0.001,OR=1.08)adiponectin(P=0.032,OR=0.93),TNF-α(P=0.015,OR=1.19),Chemerin/HDL-C(P<0.001,OR=1.07)and Chemerin/adiponectin(P=0.005,OR=1.33)were potential risk factors for fatty pancreas.Multivariate Logistic regression analysis showed that Chemerin/HDL-C(P=0.046,OR=1.07)was an independent risk factor for fatty pancreas.7.Receiver operating curve(ROC)showed that Chemerin/HDL-C was the strongest predictor of fatty pancreas predisposition(sensitivity 94%;Specificity 61%;95%CI:0.745,0.917).Conclusion:The expression level of serum Chemerin and other adipokines(leptin,TNF-α)was significantly higher in patients with fatty pancreas than in normal control group,while the expression level of serum adiponectin was significantly lower in patients with fatty pancreas than in normal control group,and there was a significant negative correlation between serum Chemerin level and adiponectin.Chemerin/HDL-C is an independent risk factor for fatty pancreas and has important predictive value for the occurrence of fatty pancreas.