The predictive value of serum AIFM2 and UMOD levels for acute kidney injury in patients with severe acute pancre-atitis

Liu Yujie; Shen Chen; Ma Pengfei; Zheng Youwei

doi:10.3969/j.issn.1671-6450.2024.11.013

Abstract：Objective To investigate the levels of serum mitochondrial associated apoptosis factor 2(AIFM2)and uromodulin(UMOD)in patients with severe acute pancreatitis(SAP),and their predictive value for acute kidney injury(AKI)in SAP.Methods One hundred and eighty-two SAP patients(SAP group)treated at the First Affiliated Hospital of Henan University of Science and Technology from March 2020 to March 2023 were selected.Based on whether they had concurrent AKI,the SAP group was divided into a non-AKI group(132 cases)and an AKI group(50 cases),with 60 healthy individuals as the control group during the same period.Enzyme linked immunosorbent assay was used to detect serum AIFM2 and UMOD levels.The evaluation value of serum AIFM2 and UMOD for SAP complicated with AKI was as-sessed using logistic regression model and receiver operating characteristic curve.Results The serum AIFM2 level in the SAP group was higher than that in the control group,and the serum UMOD level was lower than that in the control group(t=25.618,48.340,P＜0.001).The serum AIFM2 level,blood urea nitrogen level,blood creatinine level,and Ranson score in the AKI group were higher than those in the non-AKI group,and the serum UMOD level was lower than that in the non-AKI group(t/P=45.463/＜0.001,26.748/＜0.001,27 264/＜0.001).The serum creatinine,blood urea nitrogen,cystatin C,and Ranson score of AKI group SAP patients were positively correlated with serum AIFM2(r/P=0.725/＜0.001,0.621/＜0.001,0.637/＜0.001)and negatively correlated with serum UMOD(r/P=-0.710/＜0.001,-0.636/＜0.001,-0.671/＜0.001).Blood urea nitrogen,blood creatinine,Ranson score,and serum AIFM2 were risk factors for SAP complicated with AKI[OR(95％CI)=1.589(1258-2.006),1.594(1252-2.028),1.451(1.120-1.879),1.419(1.085-1.856)],while serum UMOD was a protec-tive factor[OR(95％CI)=0.628(0.493-0.799)].The area under the curve(95％CI)of serum AIFM2 and UMOD combined for the evaluation of SAP complicated AKI was 0.938(0.889-0.959),which was higher than that of serum AIFM2.UMOD single detection was 0.871(0.831～0.913)and 0.862(0.821～0.896)(Z=4.344,4.840,P=0.000,0.000).Conclusion The eleva-tion of serum AIFM2 and the decrease of UMOD in SAP complicated AKI patients are related to the severity of the dis-ease,and the combination of the two has high evaluation value for the occurrence of SAP complicated AKI.