血清网膜素-1在脓毒症中的诊断和预后价值：危重症患者的前瞻性研究。

Diagnostic and Prognostic Value of Serum Omentin-1 in Sepsis: A Prospective Study in Critically Ill Patients.

机构信息

Second Department of Critical Care, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece.

Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

出版信息

Medicina (Kaunas). 2023 Apr 24;59(5):833. doi: 10.3390/medicina59050833.

: Omentin-1, also known as intelectin-1, is a novel adipokine with anti-inflammatory activities implicated in inflammatory diseases and sepsis. We aimed to explore serum omentin-1 and its kinetics in critically ill patients early in sepsis and its association with severity and prognosis. : Serum omentin-1 was determined in 102 critically ill patients with sepsis during the first 48 h from sepsis onset and 1 week later, and in 102 age- and gender-matched healthy controls. The outcome of sepsis at 28 days after enrollment was recorded. : Serum omentin-1 at enrollment was significantly higher in patients compared to controls (763.3 ± 249.3 vs. 451.7 ± 122.3 μg/L, < 0.001) and it further increased 1 week after (950.6 ± 215.5 vs. 763.3 ± 249.3 μg/L, < 0.001). Patients with septic shock ( = 42) had higher omentin-1 compared to those with sepsis ( = 60) at enrollment (877.9 ± 241.2 vs. 683.1 ± 223.7 μg/L, < 0.001) and 1 week after (1020.4 ± 224.7 vs. 901.7 ± 196.3 μg/L, = 0.007). Furthermore, nonsurvivors ( = 30) had higher omentin-1 at sepsis onset (952.1 ± 248.2 vs. 684.6 ± 204.7 μg/L, < 0.001) and 1 week after (1051.8 ± 242 vs. 908.4 ± 189.8 μg/L, < 0.01). Patients with sepsis and survivors presented higher kinetics than those with septic shock and nonsurvivors (Δ(omentin-1)% 39.8 ± 35.9% vs. 20.2 ± 23.3%, = 0.01, and 39.4 ± 34.3% vs. 13.3 ± 18.1%, < 0.001, respectively). Higher omentin-1 at sepsis onset and 1 week after was an independent predictor of 28-day mortality (HR 2.26, 95% C.I. 1.21-4.19, = 0.01 and HR: 2.15, 95% C.I. 1.43-3.22, < 0.001, respectively). Finally, omentin-1 was significantly correlated with the severity scores, the white blood cells, coagulation biomarkers, and CRP, but not procalcitonin and other inflammatory biomarkers. : Serum omentin-1 is increased in sepsis, while higher levels and lower kinetics during the first week of sepsis are associated with the severity and 28-day mortality of sepsis. Omentin-1 may be a promising biomarker of sepsis. However, more studies are needed to explore its role in sepsis.

血清网膜素-1 及其动力学在脓毒症患者早期的变化及其与严重程度和预后的关系

目的探讨脓毒症患者早期血清网膜素-1（omentin-1）及其动力学变化及其与严重程度和预后的关系。

方法选取 102 例脓毒症患者（脓毒症组）和 102 例年龄和性别匹配的健康对照者（对照组），在发病后 48 小时内和 1 周后测定血清网膜素-1。记录患者入院后 28 天的预后。

结果与对照组相比，脓毒症患者入院时血清网膜素-1水平明显升高（763.3 ± 249.3 比 451.7 ± 122.3 μg/L，<0.001），1 周后进一步升高（950.6 ± 215.5 比 763.3 ± 249.3 μg/L，<0.001）。与脓毒症患者相比，脓毒性休克患者（42 例）入院时网膜素-1水平更高（877.9 ± 241.2 比 683.1 ± 223.7 μg/L，<0.001），1 周后更高（1020.4 ± 224.7 比 901.7 ± 196.3 μg/L，= 0.007）。此外，非幸存者（30 例）入院时网膜素-1水平更高（952.1 ± 248.2 比 684.6 ± 204.7 μg/L，<0.001），1 周后更高（1051.8 ± 242 比 908.4 ± 189.8 μg/L，<0.01）。与脓毒性休克和非幸存者相比，脓毒症患者和幸存者的网膜素-1动力学更高（网膜素-1%的变化 39.8 ± 35.9%比 20.2 ± 23.3%，= 0.01，和 39.4 ± 34.3%比 13.3 ± 18.1%，<0.001）。入院时和 1 周后网膜素-1水平升高是 28 天死亡率的独立预测因子（HR 2.26，95%可信区间 1.21-4.19，= 0.01；HR：2.15，95%可信区间 1.43-3.22，<0.001）。最后，网膜素-1与严重程度评分、白细胞、凝血生物标志物和 CRP 显著相关，但与降钙素原和其他炎症生物标志物无关。

结论血清网膜素-1在脓毒症中增加，而在脓毒症发病后 1 周内水平升高和动力学降低与脓毒症的严重程度和 28 天死亡率相关。网膜素-1可能是脓毒症有希望的生物标志物。然而，需要更多的研究来探讨其在脓毒症中的作用。