Higher urine desmosine levels are associated with mortality in patients with acute lung injury
| Autor: | Barry Starcher, Dana E. McClintock, Michael A. Matthay, Doug Hayden, Gwynne D. Church, Mark D. Eisner, B. Taylor Thompson |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Pathology Time Factors Physiology Urology Urine Lung injury Severity of Illness Index Article Desmosine chemistry.chemical_compound Predictive Value of Tests Physiology (medical) Severity of illness Tidal Volume medicine Humans In patient Tidal volume Aged Ultrasonography Tissue Survival Clinical Trials as Topic Respiratory Distress Syndrome biology business.industry Cell Biology Middle Aged Respiration Artificial chemistry Predictive value of tests biology.protein Female business Elastin |
| Zdroj: | American Journal of Physiology-Lung Cellular and Molecular Physiology. 291:L566-L571 |
| ISSN: | 1522-1504 1040-0605 |
| DOI: | 10.1152/ajplung.00457.2005 |
| Popis: | Desmosine is a stable breakdown product of elastin that can be reliably measured in urine samples. We tested the hypothesis that higher baseline urine desmosine would be associated with higher mortality in 579 of 861 patients included in the recent Acute Respiratory Distress Syndrome Network trial of lower tidal volume ventilation ( 1 ). We also correlated urine desmosine levels with indexes of disease severity. Finally, we assessed whether urine desmosine was lower in patients who received lower tidal volumes. Desmosine was measured by radioimmunoassay in urine samples from days 0, 1, and 3 of the study. The data were expressed as a ratio of urine desmosine to urine creatinine to control for renal dilution. The results show that higher baseline ( day 0) urine desmosine-to-creatinine concentration was associated with a higher risk of death on adjusted analysis (odds ratio 1.36, 95% confidence interval 1.02–1.82, P = 0.03). Urine desmosine increased in both ventilator groups from day 0 to day 3, but the average rise was higher in the 12-ml/kg predicted body weight group compared with the 6-ml/kg predicted body weight group ( P = 0.053, repeated-measures model). In conclusion, patients with acute lung injury ventilated with lower tidal volumes have lower urine desmosine levels, a finding that may reflect reduced extracellular matrix breakdown. These results illustrate the value of evaluating urinary biological markers that may have prognostic and pathogenetic significance in acute lung injury. |
| Databáze: | OpenAIRE |
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