Wang Li, Tang Dongling, Zhang Pingan
Department of Clinical Laboratory, Institute of Translational Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People's Republic of China.
Infect Drug Resist. 2023 Sep 28;16:6437-6449. doi: 10.2147/IDR.S429314. eCollection 2023.
The glucose metabolic reprogramming is an important pathological mechanism in sepsis, which involves a series of enzymes including Pyruvate kinase M2 (PKM2). The purpose of this study is to explore the diagnostic and prognostic value of serum PKM2 in sepsis patients.
This study recruited 143 sepsis patients, 91 non-sepsis patients, and 65 physical examiners, divided into sepsis group, non-sepsis group, and control group. Measure the serum PKM2 concentration of subjects, collect and analyze clinical and laboratory indicators of all subjects. Independent risk factors were selected by Logistic regression analysis. The area under curve (AUC) was calculated by plotting the receiver operating characteristic (ROC) curve to determine the diagnostic and prognostic value of biomarkers.
Compared with non-sepsis and control groups, the serum PKM2 levels in the sepsis group were significantly increased (both <0.001). PKM2 was an independent risk factor for sepsis and had the best diagnostic efficacy when combined with procalcitonin, with the AUC value of 0.9352. Patients with high levels of PKM2 were more likely to experience organ damage and had a higher incidence of septic shock. On the 1st and 3rd days of admission, the serum PKM2 levels in the septic shock group were higher than those in the sepsis group (both <0.05), with AUC values of 0.7296 and 0.6247, respectively. On the 3rd and 7th days of admission, the serum PKM2 levels in the non-survival group were significantly higher than those in the survival group (both <0.001), with AUC values of 0.7033 and 0.8732, respectively.
The serum PKM2 levels in sepsis patients are significantly increased and correlated with disease severity and clinical outcomes. PKM2 may be a new diagnostic and prognostic biomarker for sepsis.
葡萄糖代谢重编程是脓毒症重要的病理机制，涉及包括丙酮酸激酶M2（PKM2）在内的一系列酶。本研究旨在探讨血清PKM2在脓毒症患者中的诊断和预后价值。
本研究纳入143例脓毒症患者、91例非脓毒症患者和65例体检者，分为脓毒症组、非脓毒症组和对照组。测定受试者血清PKM2浓度，收集并分析所有受试者的临床和实验室指标。通过Logistic回归分析选择独立危险因素。绘制受试者工作特征（ROC）曲线计算曲线下面积（AUC），以确定生物标志物的诊断和预后价值。
与非脓毒症组和对照组相比，脓毒症组血清PKM2水平显著升高（均P<0.001）。PKM2是脓毒症的独立危险因素，与降钙素原联合时诊断效能最佳，AUC值为0.9352。PKM2水平高的患者更易发生器官损害，脓毒性休克发生率更高。入院第1天和第3天，脓毒性休克组血清PKM2水平高于脓毒症组（均P<0.05），AUC值分别为0.7296和0.6247。入院第3天和第7天，未存活组血清PKM2水平显著高于存活组（均P<0.001），AUC值分别为0.7033和0.8732。
脓毒症患者血清PKM2水平显著升高，且与疾病严重程度和临床结局相关。PKM2可能是脓毒症新的诊断和预后生物标志物。
