Evaluation of serum levels of Interleukin-4 in Egyptian patients with refractory gastroesophageal reflux disease

Figures & data

Table 1. Comparison of age and gender between the patients with GERD and R-GERD

Indices	GERD		Refractory GRED		Total		Tests
	N	%	N	%	N	%	t or X^2	P-value
Sex
Female	17	68.0	14	56.0	31	62.0	0.764	0.382
Male	8	32.0	11	44.0	19	38.0
Age (years)
Mean±SD	45.36 ± 13.42		48.36 ± 14.59				0.757	0.453

Table 2. Comparison of co-morbidities between the patients with GERD and R-GERD

Co-morbidities	GERD		Refractory GERD		Total		Chi-square
	N	%	N	%	N	%	X^2	P-value
Hypertension	6	24.0	7	28.0	13	26.0	0.104	0.747
Diabetes Mellitus	5	20.0	6	24.0	11	22.0	0.117	0.733
Fatty liver	1	4.0	1	4.0	2	4.0	0.000	1.000
Renal Impairment	1	4.0	1	4.0	2	4.0	0.000	1.000
Bronchial Asthma	0	0.0	1	4.0	1	2.0	1.020	0.312

Table 3. Comparison of serum levels of IL-4 in the patients with GERD and R-GERD

Groups	Interleukin-4 (Pg/ml)		T-test
	Range	Mean±SD	T	P-value
GERD	0.12–182	37.31 ± 56.07	2.608	0.012*
Refractory GRED	0.14–350	102.78 ± 112.29

Table 4. Comparison of results of routine laboratory investigations in the patients with GERD and R-GERD

			T-test
Investigations	GERDMean±SD	Refractory GERDMean±SD	T	P- Value
HB (g/dl)	11.80 ± 1.26	11.94 ± 1.42	0.379	0.706
WBCs (10^3/mm^3)	5.86 ± 1.18	6.17 ± 1.09	0.972	0.336
Platelets (10^3/mm^3)	221.92 ± 40.90	233.88 ± 49.47	0.932	0.356
ALT (U/L)	34.24 ± 6.02	34.60 ± 6.94	0.196	0.845
AST (U/L)	36.32 ± 8.11	37.40 ± 8.15	0.470	0.641
Total bilirubin (mg/dl)	0.90 ± 0.26	0.90 ± 0.26	0.054	0.957
Direct bilirubin (mg/dl)	0.24 ± 0.17	0.21 ± 0.14	0.604	0.549
Indirect bilirubin (mg/dl)	0.66 ± 0.12	0.69 ± 0.14	0.824	0.414
Creat. (mg/dl)	0.92 ± 0.33	0.92 ± 0.38	0.040	0.968
Urea (mg/dl)	27.12 ± 7.06	29.36 ± 6.71	1.149	0.256
Na (mEq/L)	140.80 ± 3.15	142.56 ± 4.03	1.720	0.092
K (mEq/L)	4.07 ± 0.40	4.18 ± 0.45	0.897	0.374
PT time (sec.)	12.25 ± 0.71	12.01 ± 0.61	1.297	0.201
PT activity %	85.40 ± 7.99	89.16 ± 6.40	1.836	0.073
INR	1.15 ± 0.10	1.10 ± 0.07	1.961	0.056
PTT (sec.)	33.04 ± 3.37	32.05 ± 2.97	1.100	0.277

Table 5. Comparison of Endoscopic features in the patients with GERD and R-GERD

Endoscopic Features	GERD		Refractory GERD		Total		Chi-square
	N	%	N	%	N	%	X^2	P-value
Reflux esophagitis	25	100.0	18	72.0	43	86.0	8.140	0.004*
Pan gastritis	15	60.0	9	36.0	24	48.0	2.885	0.089
hiatus hernia	6	24.0	10	40.0	16	32.0	1.471	0.225
Incompetent cardia	9	36.0	7	28.0	16	32.0	0.368	0.544
Gastric biliary reflux	2	8.0	7	28.0	9	18.0	3.388	0.066
Distorted Z line	1	4.0	3	12.0	4	8.0	1.087	0.297
Duodenitis	4	16.0	5	20.0	9	18.0	0.136	0.713
Pre pyloric ulcers	4	16.0	2	8.0	6	12.0	0.758	0.384
Barrett’s esophagitis	0	0.0	7	28.0	7	14.0	8.140	0.004*
Multiple angiodysplastic spots ablatedwith APC	0	0.0	1	4.0	1	2.0	1.020	0.312
gastric ulcer	1	4.0	1	4.0	2	4.0	0.000	1.000
Lower end esophageal Ulcers	2	8.0	3	12.0	5	10.0	0.222	0.637
duodenal ulcers	1	4.0	0	0.0	1	2.0	1.020	0.312
Diffuse antritis	4	16.0	1	4.0	5	10.0	2.000	0.157
Pre pyloric Erosion	3	12.0	0	0.0	3	6.0	3.191	0.074
Pre pyloric Diverticula	1	4.0	0	0.0	1	2.0	1.020	0.312

Table 6. Comparison of Pathological Findings in the patients with GERD and R-GERD

Pathological Findings		GERD		Refractory GERD		Total
		N	%	N	%	N	%
Mild		10	40.0	0	0.0	10	20.0
Moderate		13	52.0	4	16.0	17	34.0
Severe		2	8.0	14	56.0	16	32.0
Barrett’s		0	0.0	7	28.0	7	14.0
Total		25	100.0	25	100.0	50	100.0
Chi- Square	X^2	30.765
	P-value	<0.001**

Table 7. Relation between Pathological findings and (IL-4 with Routine Laboratory investigations) in the patients with GERD

Investigations	Mild (N = 10)		Moderate (N = 13)		Severe (N = 2)		ANOVA
	Mean	SD	Mean	SD	Mean	SD	F	P-value
Interleukin-4 (Pg/ml)	11.51	25.33	41.30	56.36	140.37	58.88	6.528	0.006*
HB (g/dl)	12.17	1.39	11.58	1.23	11.35	0.07	0.734	0.491
WBCs (10^3/mm^3)	6.06	1.40	5.69	1.13	5.95	0.07	0.262	0.772
Platelets (10^3/mm^3)	222.10	43.43	226.54	41.81	191.00	2.83	0.635	0.540
ALT (U/L)	31.30	3.16	35.54	7.00	40.50	2.12	3.013	0.070
AST (U/L)	33.50	4.03	37.15	9.83	45.00	5.66	1.967	0.164
Total bilirubin(mg/dl)	0.78	0.12	0.99	0.32	0.90	0.14	2.023	0.156
Direct bilirubin(mg/dl)	0.18	0.05	0.29	0.23	0.22	0.02	1.167	0.330
Indirect bilirubin(mg/dl)	0.60	0.10	0.70	0.13	0.69	0.12	2.183	0.136
Creat. (mg/dl)	0.92	0.16	0.81	0.17	1.05	0.42	1.990	0.161
Urea (mg/dl)	26.80	4.92	27.54	5.21	30.04	5.38	0.341	0.715
Na (mEq/L)	140.10	3.18	141.31	3.30	141.00	2.83	0.399	0.676
K (mEq/L)	4.04	0.39	4.08	0.39	4.20	0.71	0.129	0.880
PT time (sec.)	12.23	0.76	12.26	0.65	12.32	1.36	0.015	0.985
PT activity %	87.50	9.65	84.23	6.49	82.50	10.61	0.595	0.560
INR	1.13	0.12	1.16	0.07	1.19	0.13	0.438	0.651
PTT (sec.)	33.60	2.88	32.69	3.75	32.50	4.95	0.217	0.806

Table 8. Relation between Pathology Findings and IL-4 with Routine Laboratory investigations in the patients with R-GERD

Investigations	Moderate (N = 4)		Severe (N = 14)		Barrett’s (N = 7)		ANOVA
	Mean	SD	Mean	SD	Mean	SD	f	P-value
Interleukin-4 (Pg/ml)	64.23	73.83	49.06	56.24	232.25	116.54	12.958	<0.001**
HB (g/dl)	12.90	0.80	11.41	1.44	12.47	1.29	2.718	0.088
WBCs (10^3/mm^3)	5.30	0.50	6.42	1.21	6.17	0.89	1.765	0.195
Platelets (10^3/mm^3)	223.00	37.99	238.79	52.57	230.29	54.10	0.171	0.844
ALT (U/L)	32.75	5.12	35.14	7.94	34.57	6.32	0.172	0.843
AST (U/L)	37.00	6.98	38.50	9.10	35.43	7.41	0.318	0.731
Total bilirubin (mg/dl)	0.80	0.18	0.98	0.31	0.81	0.13	1.326	0.286
Direct bilirubin (mg/dl)	0.15	0.09	0.25	0.18	0.18	0.06	1.049	0.367
Indirect bilirubin (mg/dl)	0.65	0.10	0.73	0.17	0.64	0.10	1.195	0.322
Creat.(mg/dl)	0.95	0.37	0.97	0.45	0.79	0.18	0.567	0.575
Urea (mg/dl)	32.50	5.92	29.64	7.31	27.00	5.80	0.873	0.432
Na (mEq/L)	143.25	3.30	142.86	4.09	141.57	4.65	0.289	0.752
K (mEq/L)	4.35	0.19	4.28	0.54	3.89	0.17	2.312	0.123
PT time (sec.)	12.17	0.34	12.05	0.71	11.83	0.53	0.465	0.634
PT activity %	86.88	3.75	89.43	6.82	89.93	7.19	0.299	0.744
INR	1.13	0.04	1.10	0.08	1.10	0.08	0.240	0.788
PTT (sec.)	31.75	3.30	31.59	3.01	33.14	2.85	0.643	0.536

Table 9. Statistical analysis of IL-4 levels between GERD and Refractory GERD patients for ROC curve

Statistical Indices
Cut off	Sens.	Spec.	PPV	NPV	Accuracy
> 58.25 *	56.0	76.0	70.0	63.3	63.2

Figure 1. ROC curve (Receiver operator characteristic curve); Accuracy (area under ROC curve) of Interleukin-4 among GERD and R-GERD

Figure 2. Cut off value of Interleukin-4 by sensitivity and specificity of patients with GERD and R-GERD