The prognostic and diagnostic value of serum pyroprotein levels in assessing the severity of acute liver injury in sepsis patients

Abstract

Abstract: Objective To investigate the diagnostic and prognostic significance of serum pyroprotein in assessing the severity and outcome of acute liver injury in sepsis patients. Methods Patients with sepsis admitted to our hospital from May 2019 to April 2022 were enrolled as research subjects and divided into acute liver injury group and non-liver injury groups, according to the diagnostic criteria for acute liver injury. Upon admission, serum samples were collected from the patients to measure leves of pyroprotein, Caspase-1 and Gastermin-D (GSDMD). The research further classified the types of sepsis accompanied by acute liver injury into three categories: high bilirubin type, high transaminase type, and combined high bilirubin and high transaminase type. Additionally, the prognosis of sepsis patients with acute liver injury was evaluated in terms of survival and mortality outcomes. Results In patients with acute liver injury, serum Caspase-1 and GSDMD levels were significantly elevated, measuring(1446.40±351.11) pg/mL and (8.21±2.04) ng/mL respectively, compared to (1021.35±288.32) pg/mL and (6.59±1.57) ng/mL in patients without liver injury (P<0.05). These levels showed a positive correlation with C-reactive protein, procalcitonin, APACHE II and SOFA scores in acute liver injury cases. Notably, in the subset of patients exhibiting both high bilirubin and high transaminase levels, Caspase-1 and GSDMD were found at (1906.02±332.32) pg/mL and (9.94±1.97) ng/mL, respectively. These levels were higher than those in patients with only high transaminase (1333.77±267.70 pg/mL, 7.74±1.28 ng/mL) and those with only high bilirubin (1318.12±270.93 pg/mL, 7.54±2.04 ng/mL) within the acute liver injury group, Furthermore, the serum levels of Caspase-1 and GSDMD in patients who succumbed to their condition were (1685.37±328.10) pg/mL, (9.76±1.61) ng/mL, respectively, significantly higher than those who survived, who presented with levels of (1275.70±256.33) pg/mL, (7.10±1.53) ng/mL(P<0.05). This indicates that serum Caspase-1 and GSDMD levels had diagnostic relevance for identifying high bilirubin and high transaminase types, as well as prognostic value in predicting mortality among sepsis patients with acute liver injury. Conclusion The serum levels of Caspase-1 and GSDMD are elevated in sepsis patients with acute liver injury, indicating their significant value in assessing the severity and predicting the prognosis of the condition.

Key words: Sepsis, Acute liver injury, Pyroptosis, Caspase-1, Gasdermin-D, Prognosis

SHANG De-min, HE Tong. The prognostic and diagnostic value of serum pyroprotein levels in assessing the severity of acute liver injury in sepsis patients[J]. Chinese Hepatolgy, 2024, 29(2): 215-219.

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