BDNF and Oncostatin M in sepsis and septic shock.

배경 In sepsis, the systemic response systemic inflammatory response of the host to pathogens, host factors with poor prognosis include old age, frailty, and sarcopenia. Biomarkers to evaluate the diagnosis and severity of sepsis may be critical for adequate clinical decision and help improve the prognosis of sepsis. Among biomarkers, this study was conducted to evaluate the association between the myokine, cytokines produced and secreted by muscle cells, and the diagnosis and prognosis of sepsis, and also to evaluate whether myokine is associated with muscle mass. 방법 A prospective cohort study was conducted among adult sepsis patients who visited the emergency room of Korea University Ansan Hospital from January 2016 to January 2020. The myokines measured in this study were brain-derived neutrotrophic factor oncostatin M. Muscle mass index was measured by a board-certified radiologist on axial images of L3 vertebra level in patients underwent abdomen CT scan at the time of admission for sepsis. 결과 During the study population, 627 sepsis patients were included in the study. Of these, myokines were measured in 168 patients, and 66 patients (39.2%) were diagnosed as septic shock. The median SOFA score was 8 in sepsis group and 11 in septic shock group. The initial lactate levels were 2.5 and 5.6 mmol/L in sepsis and septic shock, respectively. In-hospital mortality rate was 39.3%, and the 7-, 14-, and 28-day mortality rates were 13.7%, 21.4%, and 26.8%, respectively. Among myokines, the median value of BDNF were 11.2ng/mL and 10ng/mL in sepsis and septic shock, respectively. The median value of oncostatin M were 102pg/mL and 111.6pg/mL in sepsis and septic shock, respectively. Total abdomi- nal muscle area index (TAMAI) were 34.6㎠/㎡ and 34.2㎠/㎡ in sepsis and septic shock, respectively. BDNF was statistically significantly different from sepsis (P < 0.001) and septic shock (P <0.001) com- pared with the control group, respectively. Oncostatin M in sepsis (P <0.001) and septic shock (P <0.001) were significantly different from the control group, respectively. Higher oncostatin M were asso- ciated with increased 14-day mortality (adjusted hazard ratio [aHR]: 1.01, 95% confidence interval [CI]: 1.00-1.02, P = 0.028) and 28-day mortality (aHR: 1.01, 95% CI 1.00-1.02, P = 0.010). BDNF at the di- agnosis of sepsis was statistically higher in survivors (12.15 ng/mL) than in deaths (8.19 ng/mL), where as oncostatin M showed no difference between the two groups. TAMAI showed higher value in the sur- vivors (35.23㎠/㎡) than in the deaths (30.6㎠/㎡). TAMAI did not show any association with myokines. 결론 In patients with sepsis and septic shock, BDNF was lower than that of healthy controls and oncostatin M was higher than that of healthy controls. Oncostatin M was associated with higher mortality in sepsis patients, and BDNF was significantly higher in sepsis survivors. Muscle mass did not show a significant association with myokine levels. [ABSTRACT FROM AUTHOR]