1. Association of patient weight status with plasma surfactant protein D, a biomarker of alveolar epithelial injury, in children with acute respiratory failure.
- Author
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Ward, Shan L, Dahmer, Mary K, Weeks, Heidi M, Sapru, Anil, Quasney, Michael W, Curley, Martha AQ, Liu, Kathleen D, Matthay, Michael A, and Flori, Heidi R
- Subjects
Humans ,Respiratory Insufficiency ,Obesity ,Body Weight ,Pulmonary Surfactant-Associated Protein D ,Body Mass Index ,Adolescent ,Child ,Child ,Preschool ,Infant ,Female ,Male ,Biomarkers ,acute respiratory distress syndrome ,acute respiratory failure ,alveolar epithelial injury ,body mass index ,children ,mechanical ventilation ,obesity ,pediatric ,surfactant protein D ,Nutrition ,Clinical Research ,Lung ,Rare Diseases ,Acute Respiratory Distress Syndrome ,Pediatric ,Detection ,screening and diagnosis ,4.1 Discovery and preclinical testing of markers and technologies ,Aetiology ,2.1 Biological and endogenous factors ,Respiratory ,Metabolic and endocrine ,Paediatrics and Reproductive Medicine ,Respiratory System - Abstract
Aims and objectivesAlveolar epithelial injury is a key determinant of acute respiratory failure (ARF) severity. Plasma surfactant protein D (SP-D), a biomarker of alveolar epithelial injury, is lower in obese adults with ARF compared to their lean peers. We aimed to determine if children with ARF have similar variance in plasma SP-D associated with their weight status on admission.MethodsPlasma SP-D was measured on days 0, 1, or 2 in children (1-18 years) with ARF enrolled in the genetic variation and biomarkers in children with acute lung injury and RESTORE studies. Weight classification (underweight, normal, overweight, and obese) was based on body mass index or weight-for-height z-scores. Associations between weight group and SP-D on each day were tested.ResultsInclusion criteria were met in 212 subjects, 24% were obese. There were no differences among weight groups in SP-D levels on days 0 and 1. However, on day 2, there was a statistically significant linear trend for lower SP-D levels as weight increased in both the univariate analysis (P = .02) and when adjusting for age, ethnicity, and diagnosis of pediatric acute respiratory distress syndrome (P = .05).ConclusionsObesity was associated with lower plasma SP-D levels on day 2 of ARF. This finding may be explained by altered ARF pathogenesis in obese individuals or a reduced incidence of ventilator-induced lung injury.
- Published
- 2020