Influence of Surgical Procedures on Serum Paraoxonase-1-Related Variables and Markers of Inflammation in Hospitalized Patients

Abstract

Purpose: Surgical stress is a phenomenon not completely understood from the biochemical point of view, although it produces alterations in the oxidative balance and inflammatory status. The present study aimed to investigate the alterations of the circulating levels of paraoxonase-1 (PON1)-related variables and markers of inflammation in hospitalized patients who underwent surgery. Methods: We recruited 285 hospitalized patients. Of those, 115 were hospitalized due to a surgical intervention and 170 for reasons other than surgery. The control group consisted of 128 healthy volunteers. A blood sample was obtained for the measurement of serum PON1-related variables, and C-reactive protein (CRP), chemokine (C-C motif) ligand 2 (CCL2), and procalcitonin concentrations. Results: Hospitalized patients had lower serum PON1 activities [paraoxonase: 215.6 (168.6 – 277.8) vs. 298.7 (229.7 – 382.6) U/L, p < 0.001; lactonase: 3.0 (2.3 – 3.7) vs. 5.7 (4.6 – 6.5) U/L, p < 0.001], and higher CCL2, CRP and procalcitonin concentrations than the healthy individuals. The days elapsed following surgery and the duration of the procedure itself inversely correlated with PON1-related variables, and directly correlated with CRP concentrations. Patients that were operated on by laparotomy had higher PON1 activity than patients operated on by laparoscopy. Local and regional anesthesia was associated with higher PON1 activities and lower CRP concentrations. Conclusion: These results show a decrease in PON1 activities and an increase in acute phase response in hospitalized patients undergoing surgery and support the hypothesis that these phenomena are related to post-surgical metabolic alterations.

Keywords:

• C-reactive protein
• Inflammation
• oxidative stress
• paraoxonase-1
• surgery

This article is referred to by:

The Potential Importance of Paraoxonase-1 in Surgical Patients

Abbrevation

ASA, American Society of Anesthesiologists; CCL2, chemokine (C-C motif) ligand 2; CRP, C-reactive protein; HDL, high-density lipoproteins; LDL, low-density lipoproteins; PON1, paraoxonase-1.

Acknowledgements

This study was supported by grants from the Fundació la Marató de TV3 (201807-10), Barcelona, Spain, the Instituto de Salud Carlos III (PI1102817 and PI1100130) and the Fondo Europeo de Desarrollo Regional (FEDER), Madrid, Spain. Editorial assistance was provided by Phil Hoddy at the Service of Linguistic Resources of the Universitat Rovira i Virgili.

Author contributions

SI, JC, JJ, and AC contributed to the conception and design of the study. SI, AE, ADS, IA, AHA, IFG, and AFLA contributed to the acquisition, analysis, and/or interpretation of data. SI and JC contributed to drafting and revising the manuscript, and all authors provided final approval of the version to be submitted.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.