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Inflammatory and endothelial activation biomarkers and risk of sepsis: a nested case-control study.

ABSTRACT: Elevated biomarkers of inflammation and endothelial cell activation have been associated with severity of sepsis. We sought to determine the association between these baseline markers and subsequent episodes of sepsis.We performed a nested case-control analysis using subjects from the REasons for Geographic and Racial Differences in Stroke cohort. We compared 162 sepsis cases (hospitalized for a serious infection with ?2 systemic inflammatory response syndrome criteria) with 162 nonsepsis controls (hospitalized for a serious infection but not sepsis) matched by age, sex, and observation time epoch. Using conditional logistic regression, we evaluated the associations between sepsis and baseline levels of interleukin-6 (IL-6), tumor necrosis factor ?, E-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1), adjusting for smoking status, hypertension, and chronic kidney disease.Compared with controls, individuals with higher baseline IL-6, E-selectin, and ICAM-1 were more likely to develop sepsis (P values for trend=.02, .02, .04). Baseline tumor necrosis factor ? and ICAM-1 were not associated with future sepsis (P values for trend=.29, .33).Individuals with higher baseline IL-6, E-selectin, and ICAM-1 were more likely to develop future sepsis episodes. These biomarkers may play a role in the early identification, mitigation, or prevention of sepsis.

SUBMITTER: Wang HE

PROVIDER: S-EPMC3814035 | biostudies-other | 2013 Oct

REPOSITORIES: biostudies-other

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Inflammatory and endothelial activation biomarkers and risk of sepsis: a nested case-control study.

Wang Henry E HE Shapiro Nathan I NI Griffin Russell R Safford Monika M MM Judd Suzanne S Howard George G

Journal of critical care 20130212 5

<h4>Purpose</h4>Elevated biomarkers of inflammation and endothelial cell activation have been associated with severity of sepsis. We sought to determine the association between these baseline markers and subsequent episodes of sepsis.<h4>Materials and methods</h4>We performed a nested case-control analysis using subjects from the REasons for Geographic and Racial Differences in Stroke cohort. We compared 162 sepsis cases (hospitalized for a serious infection with ≥2 systemic inflammatory respons ...[more]

PMID: 23414982

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Project description:RationaleCross-sectional studies demonstrate an association between metabolic syndrome and impaired lung function.ObjectivesTo define if metabolic syndrome biomarkers are risk factors for loss of lung function after irritant exposure.MethodsA nested case-control study of Fire Department of New York personnel with normal pre-September 11th FEV(1) and who presented for subspecialty pulmonary evaluation before March 10, 2008. We correlated metabolic syndrome biomarkers obtained within 6 months of World Trade Center dust exposure with subsequent FEV(1). FEV(1) at subspecialty pulmonary evaluation within 6.5 years defined disease status; cases had FEV(1) less than lower limit of normal, whereas control subjects had FEV(1) greater than or equal to lower limit of normal.Measurements and main resultsClinical data and serum sampled at the first monitoring examination within 6 months of September 11, 2001, assessed body mass index, heart rate, serum glucose, triglycerides and high-density lipoprotein (HDL), leptin, pancreatic polypeptide, and amylin. Cases and control subjects had significant differences in HDL less than 40 mg/dl with triglycerides greater than or equal to 150 mg/dl, heart rate greater than or equal to 66 bpm, and leptin greater than or equal to 10,300 pg/ml. Each increased the odds of abnormal FEV(1) at pulmonary evaluation by more than twofold, whereas amylin greater than or equal to 116 pg/ml decreased the odds by 84%, in a multibiomarker model adjusting for age, race, body mass index, and World Trade Center arrival time. This model had a sensitivity of 41%, a specificity of 86%, and a receiver operating characteristic area under the curve of 0.77.ConclusionsAbnormal triglycerides and HDL and elevated heart rate and leptin are independent risk factors of greater susceptibility to lung function impairment after September 11, 2001, whereas elevated amylin is protective. Metabolic biomarkers are predictors of lung disease, and may be useful for assessing risk of impaired lung function in response to particulate inhalation.

Dataset Information

Inflammatory and endothelial activation biomarkers and risk of sepsis: a nested case-control study.

Publications

Inflammatory and endothelial activation biomarkers and risk of sepsis: a nested case-control study.

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