Guan Linsai, Wang Feiyao, Chen Jingni, Xu Yanxin, Zhang Weixing, Zhu Jianping
Department of Nursing, Shanghai Taikang Shenyuan Rehabilitation Hospital, Shanghai, China.
Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Nutr. 2024 Sep 4;11:1442203. doi: 10.3389/fnut.2024.1442203. eCollection 2024.
To assess the potential value of fibroblast growth factor 19 (FGF19) as a predictor of gastrointestinal (GI) dysfunction in patients with sepsis.
A prospective study was conducted, and 209 patients who were diagnosed with sepsis and admitted to the intensive care unit (ICU) at teaching hospitals in China were enrolled from June 2023 to December 2023. The serum FGF19 level was determined at ICU admission. The differences in serum FGF19 levels between the two groups were compared via the Mann-Whitney U test, and Spearman's correlation coefficient was used to identify the correlations of the FGF19 concentration with other clinical variables and biomarkers. Receiver operating characteristic (ROC) analysis was used to determine the value of FGF19 in predicting GI dysfunction in patients with sepsis.
The total ICU mortality rate was 13.3% (24/180). There was a tendency toward increased ICU mortality in patients with sepsis-associated GI dysfunction compared with patients without GI dysfunction with statistical significance (21.9% vs. 8.6%, = 0.031). Serum FGF19 levels were significantly higher in patients with sepsis-associated GI dysfunction than in patients without GI dysfunction [355.1 (37.2, 2315.4) μg/mL vs. 127.4 (5.7, 944.2) μg/mL, = 0.003]. The results of receiver operating characteristic (ROC) curve analysis revealed that the area under the ROC curve (AUC) for the ability of FGF19 to predict GI dysfunction in patients with sepsis was 0.773 (95% CI 0.712 ~ 0.827), which was greater than the predictive capacity of PCT [AUC = 0.632 (95% CI 0.562 ~ 0.804)].
Serum FGF19 could be considered as a novel predictor or biomarker of GI dysfunction in patients with sepsis.
评估成纤维细胞生长因子19（FGF19）作为脓毒症患者胃肠道（GI）功能障碍预测指标的潜在价值。
进行一项前瞻性研究，于2023年6月至2023年12月在中国教学医院重症监护病房（ICU）纳入209例诊断为脓毒症的患者。在入住ICU时测定血清FGF19水平。通过Mann-Whitney U检验比较两组血清FGF19水平的差异，并使用Spearman相关系数确定FGF19浓度与其他临床变量和生物标志物的相关性。采用受试者工作特征（ROC）分析确定FGF19在预测脓毒症患者GI功能障碍中的价值。
ICU总死亡率为13.3%（24/180）。与无GI功能障碍的脓毒症患者相比，伴有脓毒症相关性GI功能障碍的患者ICU死亡率有升高趋势，差异有统计学意义（21.9%对8.6%，P = 0.031）。脓毒症相关性GI功能障碍患者的血清FGF19水平显著高于无GI功能障碍的患者[355.1（37.2，2315.4）μg/mL对127.4（5.7，944.2）μg/mL，P = 0.003]。受试者工作特征（ROC）曲线分析结果显示，FGF19预测脓毒症患者GI功能障碍能力的ROC曲线下面积（AUC）为0.773（95%CI 0.712～0.827），大于降钙素原（PCT）的预测能力[AUC = 0.632（95%CI 0.562～0.804）]。
血清FGF19可被视为脓毒症患者GI功能障碍的一种新型预测指标或生物标志物。
