Diagnostic Potential of Biochemical Markers in Acute Mesenteric Ischemia: A Modern Approach
- Authors: Kochetkov F.D.1,2, Suchkov I.A.3, Zaitsev O.V.1,2, Samarina D.A.4, Antonov V.S.4
-
Affiliations:
- Ryazan State Medical University Ryazan
- Regional Clinical Hospital
- Ryazan State Medical UniversityRyazan
- Ryazan State Medical University
- Issue: Vol 106, No 3 (2025)
- Pages: 375-381
- Section: Theoretical and clinical medicine
- Submitted: 17.10.2024
- Accepted: 27.12.2024
- Published: 07.05.2025
- URL: https://kazanmedjournal.ru/kazanmedj/article/view/637176
- DOI: https://doi.org/10.17816/KMJ637176
- EDN: https://elibrary.ru/CSRVQJ
- ID: 637176
Cite item
Abstract
BACKGROUND: Early and specific diagnosis of urgent abdominal conditions is prioritized in contemporary surgical practice because it facilitates minimally invasive interventions and improves postoperative outcomes.
AIM: To assess the diagnostic value, specificity, and sensitivity of selected biochemical markers and establish reference values for identifying acute mesenteric ischemia.
MATERIAL AND METHODS: The biochemical markers of acute mesenteric ischemia were analyzed in 40 patients admitted at the Surgical Department of Ryazan Regional Clinical Hospital between January and November 2023. Two patient groups were formed: the main group included 24 patients with acute reversible mesenteric ischemia, and the control group comprised 16 patients with atherosclerotic or embolic bowel gangrene. The following candidate markers were evaluated: diamine oxidase, tumor protein p53, and nitric oxide. A prospective study was conducted. Statistical analysis was performed using StatTech 4.2.7. Quantitative variables were assessed for distribution using the Shapiro–Wilk test. The two groups were compared based on quantitative variables using the Mann–Whitney U test. The diagnostic utility of the quantitative indicators of outcome prediction was evaluated using ROC curve analysis. The cut-off quantitative variable value was determined based on the maximum Youden index.
RESULTS: Tumor protein p53 levels ≥40.30 μmol/L, diamine oxidase ≥5.59 μmol/L, and nitric oxide ≥48.13 μmol/L were predictive of acute mesenteric ischemia before the onset of irreversible bowel wall damage. The sensitivity and specificity of tumor protein p53 were 83.3% and 100%, respectively, and 100% and 94.4% for diamine oxidase and 100% and 91.1% for nitric oxide.
CONCLUSION: Diamine oxidase, tumor protein p53, and nitric oxide are good biochemical markers for the early diagnosis of acute mesenteric ischemia.
Full Text

About the authors
Fedor D. Kochetkov
Ryazan State Medical University Ryazan; Regional Clinical Hospital
Author for correspondence.
Email: kochetkovf@bk.ru
ORCID iD: 0000-0001-6646-8595
SPIN-code: 9806-5369
Assistant Lecturer, Depart. of Faculty Surgery surgeon, Depart. of Emergency Surgery
Russian Federation, 9 Vysokovoltnaya st, Ryazan, 390026; RyazanIgor A. Suchkov
Ryazan State Medical UniversityRyazan
Email: suchkov_med@mail.ru
ORCID iD: 0000-0002-1292-5452
SPIN-code: 6473-8662
MD, Dr. Sci. (Medicine), Professor, Depart. of Cardiovascular, X-ray Endovascular Surgery and Radiology
Russian Federation, 9 Vysokovoltnaya st, Ryazan, 390026Oleg V. Zaitsev
Ryazan State Medical University Ryazan; Regional Clinical Hospital
Email: ozaitsev@yandex.ru
ORCID iD: 0000-0002-1822-3021
SPIN-code: 4556-7922
MD, Dr. Sci. (Medicine), Professor, Depart. of Hospital Surgery
Russian Federation, 9 Vysokovoltnaya st, Ryazan, 390026; RyazanDarya A. Samarina
Ryazan State Medical University
Email: daryhay.foreve@gmail.com
ORCID iD: 0009-0005-1531-6547
SPIN-code: 7210-8326
6th year student, Faculty of Medicine
Russian Federation, 9 Vysokovoltnaya st, Ryazan, 390026Vasily S. Antonov
Ryazan State Medical University
Email: nazcap88@gmail.com
ORCID iD: 0009-0009-6875-2763
5th year student, Faculty of Medicine
Russian Federation, 9 Vysokovoltnaya st, Ryazan, 390026References
- Ponomareva AD, Leiderman IN, Kasherininov IY. Acute mesenteric ischemia in patients in critical conditions. The possibilities of laboratory diagnostics. A systematic review of the literature and meta-analysis of the data. Russian Sklifosovsky Journal of Emergency Medical Care. 2022;11(2):317–323. doi: 10.23934/2223-9022-2022-11-2-317-323 EDN: BWDQHH
- Otto CC, Czigany Z, Heise D, et al. Prognostic factors for mortality in acute mesenteric ischemia. J Clin Med. 2022;11:3619. doi: 10.3390/jcm11133619 EDN: YYBDLW
- Reintam Blaser A, Starkopf J, Björck M, et al. Diagnostic accuracy of biomarkers to detect acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis. World J Emerg Surg. 2023;18:44. doi: 10.1186/s13017-023-00512-9 EDN: PRKTSY
- Pankratov AA, Peredonov SN, Zelenin DA, et al. Acute mesenteric ischemia — an incurable situation? The current state of the problem. Surgery. Pirogov Russian Journal of Surgery. 2020;(12):105–110. doi: 10.17116/hirurgia2020121105 EDN: MDKUHU
- Shapovalova NS. Noninvasive biomarkers: citrulline and intestinal proteins as a tool for diagnosis and control of intestinal mucosal damage. Medicine: Theory and Practice. 2019;3(3 attached):44–48. Available from: https://ojs3.gpmu.org/index.php/med-theory-and-practice/article/view/342
- Olkova MV, Petrushenko VS, Ponomarev GY. Analysis of the frequencies of 13 polymorphisms in the tp53 and wrap53 genes in russian populations. Bulletin of the Russian State Medical University. 2021;(1):33–42. doi: 10.24075/vrgmu.2021.001
- Cakmaz R, Büyükaşık O, Kahramansoy N, et al. A combination of plasma DAO and citrulline levels as a potential marker for acute mesenteric ischemia. Libyan J Med. 2013;8(1):20596. doi: 10.3402/ljm.v8i0.20596
- Khavkin AI, Novikova VP, Shapovalova NS. Promising noninvasive biomarkers: intestinal proteins in the diagnosis of intestinal mucosal lesions. Experimental and clinical gastroenterology. 2021;188(4):155–160. doi: 10.31146/1682-8658-ecg-188-4-155-160
- Khripun AI, Pryamikov AD, Mironkov AB, Alimov AN. Acute mesenteric ischemia — a 15-year experience of surgical treatment in a multi-field hospital. Pirogov Russian Journal of Surgery. 2023;(6):6–12. doi: 10.17116/hirurgia20230616
- Puzdryak PD, Schwartz EYu, Ivanov MA, et al. Multidisciplinary an approach to the treatment of acute mesenteric ischemia and its outcomes. Cardiology and cardiovascular surgery. 2023;16(1):103–109. doi: 10.17116/kardio202316011103 EDN: INMLPE
- Sergeev AN, Morozov AM, Kadykov VA, et al. Treatment of mesenteric thrombosis in the aspect of early thrombectomy from the mesenteric artery. Eruditio Juvenium. 2020;8(2):303–311. doi: 10.23888/HMJ202082303-311 EDN: WUGXQF
- Zvyagin AA, Bavykina IA, Nastusheva TL, Bavykin DV. Intestinal protein binding fatty acids as a promising marker of small intestine permeability. Russian Bulletin of Perinatology and Pediatrics. 2020;65:(6):29–33. doi: 10.21508/1027-4065-2020-65-6-29-33 EDN: PDPRHM
- Gumanova NG. Nitric oxide, its circulating metabolites NOx and their role in the functioning of the human body and the prognosis of the risk of cardiovascular death (part I). Preventive medicine. 2021;24(9):102–109. doi: 10.17116/profmed202124091102 EDN: VOEXBV
- Kärkkäinen JM. Acute Mesenteric Ischemia: A Challenge for the Acute Care Surgeon. Scand J Surg. 2021;110(2):150–158. doi: 10.1177/14574969211007590 EDN: LJAMCH
- Bala M, Catena F, Kashuk J, et al. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2022;17(1):54. doi: 10.1186/s13017-022-00443-x
- Puzdryak PD, Shvarts EYu, Ivanov MA, et al. Multidisciplinary approach to the treatment of acute mesenterial ischemia and its outcomes. Russian Journal of Cardiology and Cardiovascular Surgery. 2023;16(1):103–109. doi: 10.17116/kardio202316011103 EDN: INMLPE
- Lendzion RJ, Frahm-Jensen G, Keck J. Acute Mesenteric Ischemia. Clin Colon Rectal Surg. 2022;35(3):227–236. doi: 10.1055/s-0042-1743283 EDN: OWPDYC
- Higashijima U, Sekino M, Iwasaki N, et al. Acute mesenteric ischemia diagnosed using the aquarium sign: A case report. Medicine. 2023;102(19):e33735. doi: 10.1097/MD.0000000000033735 EDN: NHTQDY
- Ahmed M. Ischemic bowel disease in 2021. World J Gastroenterol. 2021;27(29):4746–4762. doi: 10.3748/wjg.v27.i29.4746
- Ksouri A, Copin P, Bonvalet F, et al. Colonic involvement in acute mesenteric ischemia: prevalence, risk factors, and outcomes. Eur Radiol. 2022;32(4):2813–2823. doi: 10.1007/s00330-021-08318-6 EDN: ECUAIQ
- Kunychka M, Váňa J, Žáček M, Chromčiková M. Acute mesenteric ischemia – a persistent problem. Rozhl Chir. 2023;102(6):228–235. English. doi: 10.33699/PIS.2023.102.6.228-235
- Kalinin RE, Suchkov IA, Klimentova EA, et al. Apoptosis in vascular pathology: present and future. I.P. Pavlov Russian Medical Biological Herald. 2020;28(1):79–87. doi: 10.23888/PAVLOVJ202028179-87 EDN: ENKILV
Supplementary files
