Forsberg Felix, Ruge Toralph, Larsson Anders, Wändell Per, Carlsson Axel C, Nilsson Peter M, Swärd Per
Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Skåne University Hospital, Lund University, 205 02, Malmö, Sweden.
Department of Clinical Sciences Malmö & Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden.
Sci Rep. 2025 Apr 23;15(1):14198. doi: 10.1038/s41598-025-96640-0.
High levels of circulating angiotensin converting enzyme 2 (ACE2) are associated with several chronic diseases and mortality risk. Less is known about the prognostic value of ACE2 in patients with sepsis. In the present study, we aimed to investigate the association between plasma ACE2 levels on admission to the ED and 28-day mortality, organ failure, and level of care in a prospectively recruited observational study sample. Six hundred patients with sepsis admitted to the emergency in Malmö 2013-2015 were included in the analysis. Uni- and multivariable binary logistic regression was conducted to investigate the association between ACE2 and 28-day mortality, organ failure, and level of care. Plasma ACE2 levels were increased in patients with male sex, high age, and comorbidities, including diabetes, cardiovascular disease, and cancer. Plasma ACE2 levels associated with hospitalization and intermediate care unit stay in univariate but not multivariate analysis. Plasma ACE2 did neither associate with 28-day mortality, OR 1.19 (95% CI 0.86-1.65, p = 0.29), nor with organ failure, OR 1.08 (95% CI 0.73-1.56. p = 0.72). Future studies investigating the dynamics of circulating ACE2 levels in patients with sepsis longitudinally are warranted.
循环血管紧张素转换酶2（ACE2）水平升高与多种慢性疾病及死亡风险相关。关于ACE2在脓毒症患者中的预后价值，人们了解较少。在本研究中，我们旨在通过一项前瞻性招募的观察性研究样本，调查急诊入院时血浆ACE2水平与28天死亡率、器官衰竭及护理级别之间的关联。分析纳入了2013年至2015年在马尔默急诊入院的600例脓毒症患者。采用单变量和多变量二元逻辑回归分析来研究ACE2与28天死亡率、器官衰竭及护理级别之间的关联。男性、高龄及患有包括糖尿病、心血管疾病和癌症在内的合并症患者的血浆ACE2水平升高。在单变量分析中，血浆ACE2水平与住院及在中级护理病房停留相关，但在多变量分析中不相关。血浆ACE2与28天死亡率（比值比1.19，95%置信区间0.86 - 1.65，p = 0.29）及器官衰竭（比值比1.08，95%置信区间0.73 - 1.56，p = 0.72）均无关联。有必要开展进一步研究，纵向调查脓毒症患者循环ACE2水平的动态变化。
