Can Fetuin-A, CRP, and WBC Levels Be Predictive Values in the Diagnosis of Acute Appendicitis in Children with Abdominal Pain?
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Statistical Analysis
2.3. Study Limitations
3. Results
4. Discussion
5. Conclusions
Author Contributions
Conflicts of Interest
References
- Karabulut, R.; Sonmez, K.; Turkyilmaz, Z.; Demirogullari, B.; Ozen, I.O.; Demirtola, A.; Basaklar, A.C.; Kale, N. Negative Appendectomy Experience in Children. Ir. J. Med. Sci. 2011, 180, 55–58. [Google Scholar] [CrossRef] [PubMed]
- Deng, Y.; Chang, D.C.; Zhang, Y.; Webb, J.; Gabre-Kidan, A.; Abdullah, F. Seasonal and Day of the Week Variations of Perforated Appendicitis in US Children. Pediatr. Surg. Int. 2010, 26, 691–696. [Google Scholar] [CrossRef] [PubMed]
- Kılıç, Ş.S. Appendicitis in Children. Med. J. SDU 2015, 22, 12–16. [Google Scholar]
- Saito, J.M.; Yan, Y.; Evashwick, T.W.; Warner, B.W.; Tarr, P.I. Use and Accuracy of Diagnostic Imaging by Hospital Type in Pediatric Appendicitis. Pediatrics 2013, 131, 37–44. [Google Scholar] [CrossRef] [PubMed]
- Weikert, C.; Stefan, N.; Schulze, M.B.; Pischon, T.; Berger, K.; Joost, H.G.; Häring, H.U.; Boeing, H.; Fritsche, A. Plasma Fetuin-A Levels and the Risk of Myocardial Infarction and Ischemic Stroke. Circulation 2008, 118, 2555–2562. [Google Scholar] [CrossRef] [PubMed]
- Fisher, E.; Stefan, N.; Saar, K.; Drogan, D.; Schulze, M.B.; Fritsche, A.; Joost, H.G.; Häring, H.U.; Hubner, N.; Boeing, H.; et al. Association of AHSG Gene Polymorphisms with Fetuin-A Plasma Levels and Cardiovascular Diseases in the EPIC-Potsdam Study. Circ. Cardiovasc. Genet. 2009, 2, 607–613. [Google Scholar] [CrossRef] [PubMed]
- Westenfeld, R.; Jahnen-Dechent, W.; Ketteler, M. Vascular Calcification and Fetuin-A Deficiency in Chronic Kidney Disease. Trends. Cardiovasc. Med. 2007, 17, 124–128. [Google Scholar] [CrossRef]
- Stefan, N.; Hennige, A.M.; Staiger, H.; Machann, J.; Schick, F.; Kröber, S.M.; Machicao, F.; Fritsche, A.; Häring, H.U. Alpha2-Heremans- Schmid Glycoprotein/Fetuin-A is Associated with Insulin Resistance and Fat Accumulation in the Liver in Humans. Diabetes Care 2006, 29, 853–857. [Google Scholar] [CrossRef]
- Demir, E. Statistics Lecture Notes. Ankara University Faculty of Educational Sciences. Ankara 2017. [Google Scholar] [CrossRef]
- Andersen, B.R.; Kallehave, F.L.; Andersen, H.K. Antibiotics Versus Placebo for Prevention of Postoperative Infection after Appendectomy. Cochrane Database Syst. Rev. 2003, CD001439. [Google Scholar] [CrossRef]
- Ates, M.; Coban, S.; Sevil, S.; Terzi, A. The Efficacy of Laparoscopic Surgery in Patients with Peritonitis. Surg. Laparosc. Endosc. Percutan. Tech. 2008, 18, 453–456. [Google Scholar] [CrossRef] [PubMed]
- Shogilev, D.J.; Duus, N.; Odom, S.R.; Shapiro, N.I. Diagnosing Appendicitis: Evidence-Based Review of the Diagnostic Approach in 2014. West. J. Emerg. Med. 2014, 15, 859–871. [Google Scholar] [CrossRef] [PubMed]
- Almaramhy, H.H. Acute Appendicitis in Young Children Less Than 5 Years: Review Article. Ital. J. Pediatr. 2017, 43, 15. [Google Scholar] [CrossRef] [PubMed]
- Gwynn, L.K. The Diagnosis of Acute Appendicitis: Clinical Assessment Versus Computed Tomography Evaluation. J. Emerg. Med. 2001, 21, 119–123. [Google Scholar] [CrossRef]
- Bundy, D.G.; Byerley, J.S.; Liles, E.A.; Perrin, E.M.; Katznelson, J.; HRice, H.E. Does This Child Have Appendicitis? JAMA 2007, 298, 438–451. [Google Scholar] [CrossRef] [PubMed]
- Marhaug, G.; Shah, V.; Shroff, R.; Varsani, H.; Wedderburn, L.R.; Pilkington, C.A.; Brogan, P.A. Age-Dependent Inhibition of Ectopic Calcification: A Possible Role for Fetuin-A and Osteopontin in Patients with Juvenile Dermatomyositis with Calcinosis. Rheumatology (Oxford) 2008, 47, 1031–1037. [Google Scholar] [CrossRef][Green Version]
- Ix, J.H.; Chertow, G.M.; Shlipak, M.G.; Brandenburg, V.M.; Ketteler, M.; Whooley, M.A. Association of Fetuin-A with Mitral Annular Calcification and Aortic Stenosis Among Persons with Coronary Heart Disease: Data from the Heart and Soul Study. Circulation 2007, 115, 2533–2539. [Google Scholar] [CrossRef] [PubMed]
- Mori, K.; Emoto, M.; Araki, T.; Yokoyama, H.; Teramura, M.; Lee, E.; Motoyama, K.; Koyama, H.; Shoji, T.; Inaba, M.; et al. Association of Serum Fetuin-A with Carotid Arterial Stiffness. Clin. Endocrinol. (Oxf.) 2007, 66, 246–250. [Google Scholar] [CrossRef]
- Bláha, V.; Mistrík, E.; Dusilová-Sulková, S.; Kalousová, M.; Andrýs, C.; Bláha, M.; Sobotka, L. Circulating Fetuin-A Predicts Early Mortality in Chronic Hemodialysis Patients. Clin. Biochem. 2009, 42, 996–1000. [Google Scholar] [CrossRef]
- Kalabay, L.; Gráf, L.; Vörös, K.; Jakab, L.; Benko, Z.; Telegdy, L.; Fekete, B.; Prohászka, Z.; Füst, G. Human Serum Fetuin A/alpha2HS-Glycoprotein Level is Associated with Long-Term Survival in Patients with Alcoholic Liver Cirrhosis, Comparison with the Child-Pugh and MELD Scores. BMC Gastroenterol. 2007, 7, 15. [Google Scholar] [CrossRef][Green Version]
- Kaden, J.J.; Reinöhl, J.O.; Blesch, B.; Brueckmann, M.; Haghi, D.; Borggrefe, M.; Schmitz, F.; Klomfass, S.; Pillich, M.; Ortlepp, J.R. Systemic and Local Levels of Fetuin-A in Calcific Aortic Valve Stenosis. Int. J. Mol. Med. 2007, 20, 193–197. [Google Scholar] [CrossRef] [PubMed]
- Zhou, Z.; Ji, Y.; Ju, H.; Chen, H.; Sun, M. Circulating Fetuin-A and Risk of All-Cause Mortality in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Front. Physiol. 2019, 10, 966. [Google Scholar] [CrossRef]
- Manolakis, A.C.; Christodoulidis, G.; Kapsoritakis, A.N.; Georgoulias, P.; Tiaka, E.K.; Oikonomou, K.; Valotassiou, V.J.; Potamianos, S.P. α2-Heremans-Schmid Glycoprotein (Fetuin-A) Downregulation and Its Utility in Inflammatory Bowel Disease. World J. Gastroenterol. 2017, 23, 437–446. [Google Scholar] [CrossRef] [PubMed]
- Karamessinis, P.M.; Malamitsi-Puchner, A.; Boutsikou, T.; Makridakis, M.; Vougas, K.; Fountoulakis, M.; Vlahou, A.; Chrousos, G. Marked Defects in the Expression and Glycosylation of alpha2-HS Glycoprotein/Fetuin-A in Plasma from Neonates with Intrauterine Growth Restriction: Proteomics Screening and Potential Clinical Implications. Mol. Cell Proteomics 2008, 7, 591–599. [Google Scholar] [CrossRef] [PubMed]
- Wang, A.Y.; Woo, J.; Lam, C.W.; Wang, M.; Chan, I.H.; Gao, P.; Lui, S.F.; Li, P.K.; Sanderson, J.E. Associations of Serum Fetuin-A with Malnutrition, Inflammation, Atherosclerosis and Valvular Calcification Syndrome and Outcome in Peritoneal Dialysis Patients. Nephrol. Dial. Transplant. 2005, 20, 1676–1685. [Google Scholar] [CrossRef]
- Ketteler, M. Fetuin-A and Extraosseous Calcification in Uremia. Curr. Opin. Nephrol. Hypertens. 2005, 14, 337–342. [Google Scholar] [CrossRef] [PubMed]
Abdominal Pain | |||||
---|---|---|---|---|---|
All Patients | Patients with | Z | p-Value | ||
OAP Group | AA Group | ||||
Baseline Characteristics | |||||
Age, mean ± SD, year | 9.04 ± 2.60 | 8.05 ± 2.12 | 10.35 ± 2.61 | −4.524 | 0.001 |
Sex, Female/Male | 46/61 | 33/28 | 13/33 | x2 = 7.143 | 0.008 |
Laboratory Finding | |||||
AST, mg/dL | 28.37 ± 16.04 | 25.10 ± 10.57 | 32.71 ± 20.57 | −1.274 | 0.202 |
ALT, mg/dL | 27.48 ± 18.26 | 24.52 ± 16.26 | 31.42 ± 20.14 | −1.921 | 0.056 |
ALP, mg/dL | 96.63 ± 40.63 | 92.70 ± 9.23 | 100.69 ± 45.03 | −1.366 | 0.176 |
CRP, mg/L | 4.19 ± 3.42 | 2.11 ± 3.38 | 6.95 ± 4.14 | −7.039 | 0.001 |
Amilaz, U/L | 90.63 ± 39.13 | 84.24 ± 38.24 | 99.11 ± 39.08 | −2.380 | 0.001 |
WBC, 103/uL | 13.12 ± 4.69 | 9.93 ± 2.75 | 17.36 ± 3.10 | −8.282 | 0.001 |
MCV, fL | 87.35 ± 9.61 | 85.60 ± 7.42 | 89.67 ± 6.67 | −2.189 | 0.029 |
MCH, pg | 29.31 ± 3.01 | 29.15 ± 3.19 | 29.53 ± 2.78 | −0.758 | 0.448 |
MCHC, g/dL | 33.35 ± 5.63 | 33.69 ± 0.79 | 32.89 ± 0.85 | −0.265 | 0.791 |
RDW, % | 14.54 ± 1.52 | 14.17 ± 1.60 | 14.64 ± 1.41 | −1.266 | 0.206 |
MPV, fL | 8.37 ± 1.14 | 8.27 ± 1.02 | 8.50 ± 1.29 | −0.753 | 0.453 |
Fetuin-A, mg/L | 231.86 ± 50.54 | 273.43 ± 10.60 | 176.72 ± 20.42 | −8.829 | 0.001 |
Abdominal Pain | |||||
---|---|---|---|---|---|
OAP Group | AA Group | X2 | p-Value | ||
n (%) | n (%) | ||||
Gender | Female | 33 (30.8) | 13 (12.2) | 7.143 | 0.008 |
Male | 28 (26.2) | 33 (30.8) | |||
Radiological Imaging | USG | 24 (22.4) | 33 (30.8) | 11.056 | 0.001 |
Abdominal CT | 37 (34.6) | 13 (12.1) | |||
Acute Abdomen | No | 61 (57.0) | 0 (0) | 107.00 | 0.001 |
Intraperitoneal | 0 (0) | 39 (36.4) | |||
Retrocolic/retrocecal | 0 (0) | 7 (6.5) | |||
Ferforation | NO | 61 (57.0) | 20 (13.1) | 24.39 | 0.001 |
Yes | 0 (0) | 26 (37.7) |
Acute Abdomen | ||||||
---|---|---|---|---|---|---|
No | IP | RC/Rc | X2 | p-Value | ||
n (%) | n (%) | n (%) | ||||
Gender | Female | 33 (30.8) | 8 (7.5) | 5 (4.8) | 13.421 | 0.008 |
Male | 28 (26.2) | 31 (29.0) | 2 (1.8) | |||
Radiological Imaging | USG | 24 (22.4) | 27 (25.2) | 6 (5.6) | 11.703 | 0.001 |
Abdominal CT | 37 (34.6) | 12 (11.2) | 1 (0.9) | |||
Abdominal Pain | OAP | 61 (57.0) | 0 (0) | 0 (0) | 107.00 | 0.001 |
AA | 0 (0) | 39 (36.4) | 7 (5.6) | |||
Perforation | No | 61 (57.0) | 20 (13.1) | 0 (0) | 50.030 | 0.001 |
Yes | 0 (0) | 19 (17.8) | 7 (5.6) |
Perforation | |||||
---|---|---|---|---|---|
OAP Group | AA Group | X2 | p-Value | ||
n (%) | n (%) | ||||
Gender | Female | 39 (36.5) | 7 (6.5) | 3.618 | 0.070 |
Male | 42 (39.2) | 19 (17.8) | |||
Radiological Imaging | USG | 36 (33.6) | 21 (19.6) | 11.056 | 0.001 |
Abdominal CT | 45 (42.1) | 5 (4.7) | |||
Acute Abdomen | No | 61 (57.0) | 0 (0) | 107.00 | 0.001 |
Intraperitoneal | 0 (0) | 19 (17.8) | |||
Retrocolic/retrocecal | 0 (0) | 7 (6.5) | |||
Abdominal Pain | OAP | 61 (57.0) | 0 (0) | 24.39 | 0.001 |
Yes | 20 (18.7) | 26 (24.3) |
Acute Abdomen | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Univariate | Multivariate | |||||||||
RS | F | β | t | p-Value | RS | F | β | t | p-Value | |
CRP | 0.297 | 44.316 | 0.545 | 6.657 | 0.001 | 0.428 | 3.741 | 0.041 | ||
WBC | 0.619 | 170.816 | 0.787 | 13.07 | 0.001 | 0.952 | 153.921 | 0.542 | 4.814 | 0.013 |
Fetuin-A | 0.906 | 1009.443 | −0.952 | −31.772 | 0.001 | −0.848 | −11.124 | 0.001 | ||
AA | 0.854 | 615.920 | 0.924 | 24.818 | 0.001 | 0.265 | 3.972 | 0.004 | ||
Perforation | 0.426 | 77.818 | 0.652 | 8.821 | 0.001 | −0.253 | −6.239 | 0.001 | ||
Age | 0.194 | 25.203 | 0.440 | 5.020 | 0.001 | |||||
Gender | 0.067 | 7.511 | 0.258 | 2.741 | 0.007 | |||||
AST | 0.056 | 6.198 | 0.236 | 2.489 | 0.014 | |||||
ALT | 0.035 | 3.839 | 0.188 | 1.959 | 0.053 | |||||
ALP | 0.010 | 1.014 | 0.098 | 1.007 | 0.316 | |||||
Amilaz | 0.036 | 3.887 | 0.189 | 1.971 | 0.051 | |||||
RI | 0.103 | 12.009 | −0.321 | −3.478 | 0.001 |
Perforation | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Univariate | Multivariate | |||||||||
RS | F | β | t | p-Value | RS | F | β | t | p-Value | |
CRP | 0.377 | 63.512 | 0.614 | 7.969 | 0.001 | 0.312 | 4.034 | 0.037 | ||
WBC | 0.482 | 97.668 | 0.694 | 9.883 | 0.001 | 0.779 | 27.547 | 0.298 | 5.531 | 0.023 |
Fetuin-A | 0.630 | 178.971 | −0.794 | −13.378 | 0.001 | −1.476 | −7.539 | 0.001 | ||
AA | 0.505 | 107.047 | 0.711 | 10.346 | 0.001 | 0.330 | 2.160 | 0.001 | ||
AB | 0.426 | 77.818 | 0.652 | 8.821 | 0.001 | −1.157 | −6.239 | 0.031 | ||
Age | 0.064 | 7.179 | 0.253 | 2.679 | 0.009 | |||||
Gender | 0.034 | 3.674 | 0.184 | 1.917 | 0.058 | |||||
AST | 0.883 | 23.581 | 0.428 | 4.856 | 0.001 | |||||
ALT | 0.154 | 19.132 | 0.393 | 4.374 | 0.001 | |||||
ALP | 0.061 | 6.789 | 0.246 | 2.606 | 0.011 | |||||
Amilaz | 0.069 | 7.818 | 0.263 | 2.796 | 0.006 | |||||
RI | 0.098 | 11.344 | −0.312 | −3.368 | 0.001 |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Güney, C.; Coskun, A. Can Fetuin-A, CRP, and WBC Levels Be Predictive Values in the Diagnosis of Acute Appendicitis in Children with Abdominal Pain? Healthcare 2019, 7, 110. https://doi.org/10.3390/healthcare7040110
Güney C, Coskun A. Can Fetuin-A, CRP, and WBC Levels Be Predictive Values in the Diagnosis of Acute Appendicitis in Children with Abdominal Pain? Healthcare. 2019; 7(4):110. https://doi.org/10.3390/healthcare7040110
Chicago/Turabian StyleGüney, Cengiz, and Abuzer Coskun. 2019. "Can Fetuin-A, CRP, and WBC Levels Be Predictive Values in the Diagnosis of Acute Appendicitis in Children with Abdominal Pain?" Healthcare 7, no. 4: 110. https://doi.org/10.3390/healthcare7040110
APA StyleGüney, C., & Coskun, A. (2019). Can Fetuin-A, CRP, and WBC Levels Be Predictive Values in the Diagnosis of Acute Appendicitis in Children with Abdominal Pain? Healthcare, 7(4), 110. https://doi.org/10.3390/healthcare7040110