This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Lipoprotein(a), lipids and proinflammatory cytokines in patients undergoing major abdominal surgery. BJS 2006; 93: 347-353.
Published: 23rd February 2006
Authors: G. Chimienti, F. Aquilino, M. T. Rotelli, F. Russo, L. Lupo, G. Pepe et al.
Background
The aims were to investigate whether surgical stress can induce a positive or negative lipoprotein(a) acute response, to determine any association with apolipoprotein(a) phenotypes, and to establish whether any such response is dependent on changes in lipids and proinflammatory cytokines. In addition, the impact of interleukin (IL) 6 genetic variability on the cytokine response to surgery was examined.
Method
This prospective, observational study included 41 patients with cancer referred for abdominal surgery. Preoperative (T0) plasma concentrations of lipoprotein(a), IL‐6, tumour necrosis factor α, and serum concentrations of transforming growth factor β1 and lipids, were compared with values obtained 5 h (T1), 24 h (T2) and 5 days (T3) after surgery. Apolipoprotein(a) Kringle IV (KIV)‐VNTR (variable‐number tandem repeat) and IL‐6 − 174 G/C polymorphisms were analysed.
Results
Lipoprotein(a) was found to act as a negative acute‐phase reactant (30·0 per cent reduction at T2) (P = 0·009). Surgery had a more profound impact on subjects with low KIV‐VNTR. After surgery, lipoprotein(a) correlated significantly with corrected low‐density lipoprotein (LDL)‐cholesterol (r = 0·408 at T2). IL‐6 inversely correlated with lipoprotein(a) (r = −0·321 at T1) and LDL‐cholesterol (r = −0·418 at T1). The IL‐6 response could be predicted from a combination of the surgical severity and −174 G/C genotype.
Conclusion
Although temporal associations did not indicate causality, these data provide a hypothesis to explain the inverse relationship between lipoprotein(a) and IL‐6. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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