Correlation of serum neutrophil gelatinase-associated lipocalin with inflammatory response and its diagnostic value for severe community-acquired pneumonia_West China Medical Journal

Authors：

KANG Guoping ¹ ,  ZHU Yu ² , YANG Huan ¹ , ZHANG Ji ¹ , CHENG Hairong ¹ , TANG Ziwen ¹ , LIU Weixian ¹

1. Emergency Department, Bazhong Central Hospital, Bazhong, Sichuan 636000, P. R. China;
2. Department of Respiratory Medicine, Bazhong Central Hospital, Bazhong, Sichuan 636000, P. R. China;

Corresponding author：

ZHU Yu, Email: taoguox@163.com

Keywords：

Community-acquired pneumonia; Severe pneumonia; Neutrophil gelatinase-associated lipocalin; C-reactive protein; Interleukin-6; Procalcitonin; Inflammatory response

DOI：

10.7507/1002-0179.201910025

Video：

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Objective To explore the correlation of serum neutrophil gelatinase-associated lipocalin (sNGAL) with inflammatory response in patients with community-acquired pneumonia (CAP) and assess the diagnostic value of sNGAL for severe CAP (SCAP).Methods From January 2018 to June 2019, a total of 85 patients with CAP were enrolled in this study. Age, length of hospital stay, the levels of serum creatinine, blood urea nitrogen, white blood cell count,C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin, and CURB-65 score were compared between patients with SCAP (n=34) and patients without SCAP (n=51). The correlations of sNGAL with serum creatinine, blood urea nitrogen, white blood cell count, CRP, IL-6, procalcitonin, and CURB-65 score were assessed with Spearman’s correlation analysis. The area under the receiver operating characteristic (ROC) curve for sNGAL diagnosing SCAP was examined. Results Compared with patients without SCAP, SCAP patients demonstrated older age, longer hospital stay, higher serum CRP and IL-6 concentritions, and higher CURB-65 score (P<0.05). The Spearman’s correlation test showed that sNGAL was positively correlated with serum CRP, IL-6, PCT and CURB-65 score (r_s=0.472, 0.504, 0.388, and 0.405, respectively; P<0.01). According to ROC analysis, the area under curve of sNGAL for diagnosing SCAP were 0.816, with a sensitivity of 76.56% and a specificity of 74.4% when the cut-off value was 171.0 ng/mL.Conclusions sNGAL concentration is positively correlated with the serverity of CAP. It can be regarded as a reliable indicator for diagnosis of SCAP in patients with CAP.

Citation： KANG Guoping, ZHU Yu, YANG Huan, ZHANG Ji, CHENG Hairong, TANG Ziwen, LIU Weixian. Correlation of serum neutrophil gelatinase-associated lipocalin with inflammatory response and its diagnostic value for severe community-acquired pneumonia. West China Medical Journal, 2020, 35(1): 17-21. doi: 10.7507/1002-0179.201910025 Copy

1.	Divino V, Schranz J, Early M, et al. The annual economic burden among patients hospitalized for community-acquired pneumonia (CAP): a retrospective US cohort study. Curr Med Res Opin, 2020, 36(1): 151-160.
2.	杨婷, 曾子鉴, 申永春, 等. 胱抑素 C 评估社区获得性肺炎患者严重程度及预测住院期间死亡概率的临床研究. 华西医学, 2018, 33(1): 28-31.
3.	Karakioulaki M, Stolz D. Biomarkers in pneumonia-beyond procalcitonin. Int J Mol Sci, 2019, 20(8): E2004.
4.	Akagi T, Nagata N. Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital. BMC Geriatr, 2019, 19(1): 3.
5.	Cuartero M, Betbesé AJ, Núñez K, et al. Does whole-blood neutrophil gelatinase-associated lipocalin stratify acute kidney injury in critically Ⅲ patients?. Dis Markers, 2019, 2019: 8480925.
6.	Jonsson N, Gille-Johnson P, Martling CR, et al. Performance of plasma measurement of neutrophil gelatinase-associated lipocalin as a biomarker of bacterial infections in the intensive care unit. J Crit Care, 2019, 53: 264-270.
7.	Kim JW, Hong DY, Lee KR, et al. Usefulness of plasma neutrophil gelatinase-associated lipocalin concentration for predicting the severity and mortality of patients with community-acquired pneumonia. Clin Chim Acta, 2016, 462: 140-145.
8.	Yeh YH, Chang JL, Hsiao PC, et al. Circulating level of lipocalin 2 as a predictor of severity in patients with community-acquired pneumonia. J Clin Lab Anal, 2013, 27(4): 253-260.
9.	中华医学会呼吸病学分会. 中国成人社区获得性肺炎诊断和治疗指南 (2016 年版). 中华结核和呼吸杂志, 2016, 4(39): 253-279.
10.	Espinoza R, Silva J, Bergmann A, et al. Factors associated with mortality in severe community-acquired pneumonia: a multicenter cohort study. J Crit Care, 2019, 50: 82-86.
11.	Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax, 2003, 58(5): 377-382.
12.	Laterre PF, Colin G, Dequin PF, et al. CAL02, a novel antitoxin liposomal agent, in severe pneumococcal pneumonia: a first-in-human, double-blind, placebo-controlled, randomised trial. Lancet Infect Dis, 2019, 19(6): 620-630.
13.	姜少雄, 李东泽, 谷志寒, 等. 入院时急性肾损伤对重症肺炎并发脓毒症患者预后的预测价值. 华西医学, 2019, 34(7): 790-795.
14.	Siljan WW, Holter JC, Michelsen AE, et al. Inflammatory biomarkers are associated with aetiology and predict outcomes in community-acquired pneumonia: results of a 5-year follow-up cohort study. ERJ Open Res, 2019, 5(1): 00014-2019.
15.	Tsai PK, Tsao SM, Yang WE, et al. Plasma soluble urokinase-type plasminogen activator receptor level as a predictor of the severity of community-acquired pneumonia. Int J Environ Res Public Health, 2019, 16(6): E1035.

1. Divino V, Schranz J, Early M, et al. The annual economic burden among patients hospitalized for community-acquired pneumonia (CAP): a retrospective US cohort study. Curr Med Res Opin, 2020, 36(1): 151-160.
2. 杨婷, 曾子鉴, 申永春, 等. 胱抑素 C 评估社区获得性肺炎患者严重程度及预测住院期间死亡概率的临床研究. 华西医学, 2018, 33(1): 28-31.
3. Karakioulaki M, Stolz D. Biomarkers in pneumonia-beyond procalcitonin. Int J Mol Sci, 2019, 20(8): E2004.
4. Akagi T, Nagata N. Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital. BMC Geriatr, 2019, 19(1): 3.
5. Cuartero M, Betbesé AJ, Núñez K, et al. Does whole-blood neutrophil gelatinase-associated lipocalin stratify acute kidney injury in critically Ⅲ patients?. Dis Markers, 2019, 2019: 8480925.
6. Jonsson N, Gille-Johnson P, Martling CR, et al. Performance of plasma measurement of neutrophil gelatinase-associated lipocalin as a biomarker of bacterial infections in the intensive care unit. J Crit Care, 2019, 53: 264-270.
7. Kim JW, Hong DY, Lee KR, et al. Usefulness of plasma neutrophil gelatinase-associated lipocalin concentration for predicting the severity and mortality of patients with community-acquired pneumonia. Clin Chim Acta, 2016, 462: 140-145.
8. Yeh YH, Chang JL, Hsiao PC, et al. Circulating level of lipocalin 2 as a predictor of severity in patients with community-acquired pneumonia. J Clin Lab Anal, 2013, 27(4): 253-260.
9. 中华医学会呼吸病学分会. 中国成人社区获得性肺炎诊断和治疗指南 (2016 年版). 中华结核和呼吸杂志, 2016, 4(39): 253-279.
10. Espinoza R, Silva J, Bergmann A, et al. Factors associated with mortality in severe community-acquired pneumonia: a multicenter cohort study. J Crit Care, 2019, 50: 82-86.
11. Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax, 2003, 58(5): 377-382.
12. Laterre PF, Colin G, Dequin PF, et al. CAL02, a novel antitoxin liposomal agent, in severe pneumococcal pneumonia: a first-in-human, double-blind, placebo-controlled, randomised trial. Lancet Infect Dis, 2019, 19(6): 620-630.
13. 姜少雄, 李东泽, 谷志寒, 等. 入院时急性肾损伤对重症肺炎并发脓毒症患者预后的预测价值. 华西医学, 2019, 34(7): 790-795.
14. Siljan WW, Holter JC, Michelsen AE, et al. Inflammatory biomarkers are associated with aetiology and predict outcomes in community-acquired pneumonia: results of a 5-year follow-up cohort study. ERJ Open Res, 2019, 5(1): 00014-2019.
15. Tsai PK, Tsao SM, Yang WE, et al. Plasma soluble urokinase-type plasminogen activator receptor level as a predictor of the severity of community-acquired pneumonia. Int J Environ Res Public Health, 2019, 16(6): E1035.

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Correlation of serum neutrophil gelatinase-associated lipocalin with inflammatory response and its diagnostic value for severe community-acquired pneumonia

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