Relationship Between Resistin Levels and Sepsis Among Children Under 12 Years of Age: A Case Control Study

Abstract

Objective: The aim of this study was to investigate the level of resistin in children with and without sepsis hospitalized in the pediatric intensive care unit (PICU) and compare them to levels in healthy subjects in order to determine the trend of resistin levels in children in PICUs and also to identify the cut-off values for positive sepsis. Methods: This was a case-control study conducted in 2014 at a children's hospital in Tabriz, Iran. Three groups were investigated, a case group comprised of patients with sepsis admitted to PICU and two control groups; one made up of patients admitted to PICU without sepsis and the other of healthy children. Variables included demographic, anthropometric (growth metric percentile), and clinical factors. Results: Patients were randomized into control group A ( n = 12, 48%), control group B ( n = 11, 44%), and the sepsis group ( n = 24, 47.1%). The difference in the means of resistin levels was significant on the first, fourth, and seventh days ( P < 0.0001) in the case and control group A. Means comparisons in the case and control group B revealed significant differences on the fourth and seventh day ( P = 0.005 and P < 0.0001, respectively) but not on the first day ( P = 0.246). The trend of resistin levels increased in the septic group (F Huynh-Feldt = 37.83, P < 0.0001). The diagnostic accuracy of resistin level was high for discriminating sepsis (area under the receiver operating characteristic curve [AUC] 0.864 [SE = 0.41]). The sensitivity was 0.824 and specificity 0.72 with a cut-off point of 5.2 ng/ml on the first day. Conclusion: In the present study, resistin level can be used as an indicator of sepsis in children admitted to PICU. However, the cut-off point based upon when a prediction could be made is different and is dependent on a variety of factors, such as control group and number of days since the first signs of sepsis.

Relevance of Biomarkers Currently in Use or Research for Practical Diagnosis Approach of Neonatal Early-Onset Sepsis

“…Some studies on adult and neonatal patients have reported elevated serum levels during inflammation and infection. The few studies conducted on newborns have suggested that this marker could be an indicator of EOS, but its diagnostic value proved to be less than that of CRP and the cut-off value could not be established with accuracy due to several factors such as control group and number of days since the first sign of sepsis [ 125 , 126 ]. Some biomarkers such as sTREM-1 (human triggering receptor expressed on myeloid cells-1), pentraxin-3 and pro-adrenomedullin, which were found to have high values in infected adults and children, failed to prove their role in neonatal EOS [ 127 ].…”

The landscape of immune dysregulation in pediatric sepsis at a single-cell resolution

“…This is also in line with our data in both human and murine sepsis, in which the biological processes enriched in the CEACAM1 gene co-expression network were assigned to negative regulation of T cell activation. In addition, the strong correlation between expression levels of RETN and CEACAM1 in the acute sepsis phase could reflect the deleterious clinical outcomes in this phase 43 .…”

Multiple organ dysfunction syndrome prediction in newborn children

“…При активации эндотелиальных клеток цитокинами наблюдается быстрое повышение (в течение 1-6 ч) уровня sICAM-1 в сыворотке крови, что делает его маркером системного воспаления. В нас тоящее время существуют разногласия относительно полезности этого маркера для диагностики EOS, поскольку некоторые авторы предложили sICAM-1 в качестве ценного маркера только в первые 4 дня жизни, а другие отметили аналогичные или даже более высокие уровни у здоровых новорожденных в первые 5 дней [40,41]; 5) програнулин -аутокринный фактор роста из 593 аминокислот, который регулирует сигнальную систему TNF/TNFR, может предсказывать сепсис и СПОН у новорожденных > 34 недель беременности [42]; 6) неоптерин -биохимический маркер иммунной активности, повышение которого определяется при клеточно-опосредованном иммунном ответе; 7) резистин (FIZZ3) -белок, богатый цистеином, который играет спорную физиологическую роль в ожирении и инсулинорезистентности и повышается при системном воспалительном ответе у новорожденных, детей и взрослых, однако его диагностическую ценность еще предстоит узнать [43,44]; 8) пресепсин (ПСП) -это белок, являющийся N-концевым фрагментом рецептора макрофагов CD14 [45]. Механизм образования ПСП связан с бактериальным фагоцитозом и расщеплением CD14 лизосомальными ферментами.…”