By : Ramy Mostafa, 1; Mohamed Afify, 2 Ahmed I.Amin, 3 Amr Saad4

Abstract

The incidence of sepsis has increased considerably since the late few decades. Sepsis became one of the major causes of death in developed countries. We became in desperate need of updated models for assessing severity of sepsis with no limitations. Therefore, the objective of this study was to determine the diagnostic role of some adipokines and oxidative stress biomarkers in assessing severity and prediction of early outcomes among septic patients. we conducted a cross-sectional analysis of individuals developing sepsis. Consecutive series of all eligible patients had a double venous blood sample drawn one on hospital admission and one after 48 hour of admission for assaying some adipokines such as lipocalin-2 (LCN 2) & resistin and some oxidative stress biomarkers such as malondialdehyde (MDA) & glutathione peroxidase activity (GPX). Admitted patients were followed up to assess early outcomes (length of hospital stay and mortality). The results identified 30 septic cases of them 4 (13%) have SIRS, 5 (17%) have sever sepsis and 21 (70%) with septic shock. We found that lipocalin-2 exhibited elevated levels after 48 hour of admission as compared with on admission measurements (102.9 vs. 85.7 pg/mL, p = <0.001).Resistin showed elevated levels on admission as compared with 48 hour of admission measurements. Malondialdehyde exhibited elevated levels after 48 hour of admission as compared with on admission measurements.Glutathione peroxidase showed significant decrease in its levels after 48 hour of admission as compared with on admission measurements.Also, we found that serum levels of lipocalin-2,resistin and malondialdehyde were significantly higher in non-survivors but glutathione peroxidase were significantly lower in nonsurvivors than survivors at 28 days -follow-up for mortality. In addition, our markers were positively correlated with APACHE II and SOFA scores respectively. It is concluded from this work that lipocalin-2, resistin, malondialdehyde and glutathione peroxidase are valuable for the risk stratification, early diagnosis and prognostication of sepsis in the ICU.

1. Association of some adipokines and oxidative stress biomarkers with septic patients.
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