Terry J Schaid (Aurora, CO / US), Mitchell J Cohen (Aurora, CO / US), Christopher Erickson (Aurora, CO / US), Kirk Hansen (Aurora, CO / US), Ernest E. Moore (Aurora, CO / US; Denver, CO / US), Angela Sauaia (Aurora, CO / US), Otto Thielen (Aurora, CO / US), William Hallas (Aurora, CO / US), Alexis Cralley (Aurora, CO / US), Ian LaCroix (Aurora, CO / US), Sanchayita Mitra (Aurora, CO / US), Monika Dzieciatkowska (Aurora, CO / US), Christopher Silliman (Aurora, CO / US; Denver, CO / US), Anirban Banerjee (Aurora, CO / US), Kenneth Jones (Aurora, CO / US), Angelo D'Alessandro (Aurora, CO / US)
Abstract text (incl. references and figure legends)
Introduction: With climbing obesity (OB) prevalence, more and more injured patients with OB are presenting to trauma centers worldwide. OB is associated with worse prognosis following trauma, but the effects of OB on multiple biochemical processes post-injury remain incompletely examined. We hypothesized that OB directly affects the metabolomic and proteomic signatures of injury, which are associated with poor outcomes.
Material and Methods: Blood was collected on arrival from injured patients at a Level I Trauma Center. Patients were categorized into Group 1 "minimally injured/no shock" (ISS<15, arrival base excess [BE]≥-6) and Group 2 "severely injured/shocked" (ISS≥15, BE<-6). OB was defined as BMI≥30 kg/m2. Plasma metabolomics and proteomics were performed using liquid chromatography coupled with mass spectrometry.
Results: Of the 97 patients included, 55 were Group 1 (33 without and 22 with OB) and 42 were Group 2 (33 without and 9 with OB). Compared to those without OB, severe injury was associated with distinct metabolomic and proteomic changes in patients with OB (Figure). These changes are consistent with a predisposition to erythrocyte oxidative damage and hemolysis, poor branched chain amino acid catabolism, altered phenylalanine/tyrosine degradation, and aberrant one-carbon/methionine metabolism. Increased soluble Fas receptor may also predispose patients with OB to excessive post-injury inflammation secondary to reduced innate immune cell apoptosis.
Conclusions: OB influences the metabolomic and proteomic responses to injury. These data suggest key metabolic and inflammatory pathologies that may underlie the propensity for organ dysfunction and adverse outcomes in trauma patients with OB. Further elucidation of OB-related biochemical changes with injury is crucial to the development of targeted therapies for this patient population.
References:
Liu et al. The effect of obesity on outcomes in trauma patients: a meta-analysis. Injury. 2013.
Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)
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