PMID- 23520452
OWN - NLM
STAT- MEDLINE
DCOM- 20130910
LR  - 20211021
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 8
IP  - 3
DP  - 2013
TI  - Association between reduction of plasma adiponectin levels and risk of bacterial 
      infection after gastric cancer surgery.
PG  - e56129
LID - 10.1371/journal.pone.0056129 [doi]
LID - e56129
AB  - BACKGROUND AND PURPOSE: Infections are important causes of postoperative 
      morbidity after gastric surgery; currently, no factors have been identified that 
      can predict postoperative infection. Adiponectin (ADN) mediates energy metabolism 
      and functions as an immunomodulator. Perioperative ADN levels and perioperative 
      immune functioning could be mutually related. Here we evaluated a potential 
      biological marker to reliably predict the incidence of postoperative infections 
      to prevent such comorbidities. METHODS: We analyzed 150 consecutive patients who 
      underwent elective gastric cancer surgery at the Shiga University of Medical 
      Science Hospital (Shiga, Japan) from 1997 to 2009; of these, most surgeries 
      (n = 100) were performed 2008 onwards. The patient characteristics and 
      surgery-related factors between two groups (with and without infection) were 
      compared by the paired t-test and chi(2) test, including preoperative ADN levels, 
      postoperative day 1 ADN levels, and ADN ratio (postoperative ADN 
      levels/preoperative ADN levels) as baseline factors. Logistic regression analysis 
      was performed to access the independent association between ADN ratio and 
      postoperative infection. Finally, receiver operating curves (ROCs) were 
      constructed to examine its clinical utility. RESULTS: Sixty patients (40%) 
      experienced postoperative infections. The baseline values of age, American 
      Society of Anesthesiologists physical status, total operating time, blood loss, 
      surgical procedure, C-reactive protein (CRP) levels, preoperative ADN levels, and 
      ADN ratio were significantly different between groups. Logistic regression 
      analysis using these factors indicated that type 2 diabetes mellitus (T2DM) and 
      ADN ratio were significantly independent variables (*p<0.05, ** p<0.01, 
      respectively). ROC analysis revealed that the useful cutoff values 
      (sensitivity/specificity) for preoperative ADN levels, ADN ratio, blood loss, 
      operating time, and CRP levels were 8.81(0.567/0.568), 0.76 (0.767/0.761), 405 g 
      (0.717/0.693), 342 min (0.617/0.614), and 8.94 mg/dl (0.583/0.591), respectively. 
      CONCLUSION: T2DM and ADN ratio were independent predictors of postoperative 
      infection and ADN ratio was the most useful predictor for postoperative 
      infection.
FAU - Yamamoto, Hiroshi
AU  - Yamamoto H
AD  - Department of Surgery, Shiga University of Medical Science, Shiga, Japan.
FAU - Maeda, Kazuhisa
AU  - Maeda K
FAU - Uji, Yoshitaka
AU  - Uji Y
FAU - Tsuchihashi, Hiroshi
AU  - Tsuchihashi H
FAU - Mori, Tsuyoshi
AU  - Mori T
FAU - Shimizu, Tomoharu
AU  - Shimizu T
FAU - Endo, Yoshihiro
AU  - Endo Y
FAU - Kadota, Aya
AU  - Kadota A
FAU - Miura, Katsuyuki
AU  - Miura K
FAU - Koga, Yusuke
AU  - Koga Y
FAU - Ito, Toshinori
AU  - Ito T
FAU - Tani, Tohru
AU  - Tani T
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130308
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (ADIPOQ protein, human)
RN  - 0 (Adiponectin)
RN  - 0 (Biomarkers)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Adiponectin/*blood
MH  - Aged
MH  - Bacterial Infections/*blood/etiology
MH  - Biomarkers/blood
MH  - Blood Loss, Surgical
MH  - C-Reactive Protein/metabolism
MH  - Diabetes Mellitus, Type 2/blood/microbiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*blood/etiology
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stomach Neoplasms/blood/microbiology/*surgery
PMC - PMC3592855
COIS- Competing Interests: This work was supported by Grant-in-Aid for Scientific 
      Research (C), a grant of the Knowledge Cluster Initiative implemented by the 
      Ministry of Education, Culture, Sports, Science, and Technology (MEXT), and also, 
      in part, by a grant from Otsuka Pharmaceutical Co., Ltd. There are no patents, 
      products in development or marketed products to declare. This does not alter the 
      authors' adherence to all the PLOS ONE policies on sharing data and materials, as 
      detailed online in the guide for authors.
EDAT- 2013/03/23 06:00
MHDA- 2013/09/11 06:00
PMCR- 2013/03/08
CRDT- 2013/03/23 06:00
PHST- 2012/09/21 00:00 [received]
PHST- 2013/01/05 00:00 [accepted]
PHST- 2013/03/23 06:00 [entrez]
PHST- 2013/03/23 06:00 [pubmed]
PHST- 2013/09/11 06:00 [medline]
PHST- 2013/03/08 00:00 [pmc-release]
AID - PONE-D-12-29192 [pii]
AID - 10.1371/journal.pone.0056129 [doi]
PST - ppublish
SO  - PLoS One. 2013;8(3):e56129. doi: 10.1371/journal.pone.0056129. Epub 2013 Mar 8.