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Correlation between Plasma Mitochondrial DNA Level and Disease Severity and Prognosis in Children with Sepsis |
SHAO Xianli, WANG Qianyun, LIU Guowen, et al |
Weifang Medical College, Shandong Weifang 261041, China |
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Abstract Objective: To analyze the correlation between plasma mitochondrial DNA (mt-DNA) levels and the severity and prognosis of children with sepsis,and to find valuable biomarkers. Methods: A total of 103 children with sepsis in the pediatric intensive care unit (ICU) of our hospital from January 2021 to March 2022 were selected as the research subjects.According to the severity,they were divided into the sepsis group with 57 cases and the severe sepsis group with 46 cases.50 cases of ICU infected children matched by gender and age during the same period were set as the infection group,and healthy children matched by gender and age during the same period were used as the control group.Plasma mt-DNA,calcitoninogen (PCT),C-reactive protein (CRP) and lactate (Lac) levels were compared between the groups. The critical illness score (PCIS),the 2nd generation Paediatric Organ Dysfunction Score (PELOD-2) and the 3rd generation Paediatric Risk of Mortality Score (PRISM III) of 57 cases in the sepsis group were compared,and the correlation between plasma mt-DNA and PCT,CRP,Lac levels and PCIS scores was analysed. According to the outcome 28 days after admission,the children were divided into a survival group and a death group.The plasma mt-DNA,PCT,CRP and Lac levels were compared between the two groups,and ROC curves were established to analyse the predictive value of plasma mt-DNA,PCT,CRP and Lac on the prognosis of children with sepsis. Results: There were significant differences in the levels of mt-DNA,PCT,CRP and Lac among the groups (P<0.05).Pairwise comparison of mt-DNA levels between groups:the severe sepsis group was higher than the sepsis group,the infection group and the control group; the sepsis group was higher than the infection group and the control group; the infection group was higher than the control group,the differences were all Statistical significance (P<0.05).Pairwise comparison of PCT,CRP and Lac levels between groups:the severe sepsis group was higher than the sepsis group,the infection group and the control group; the sepsis group and the infection group were higher than the control group,and the Lac level in the sepsis group was higher than In the infection group,the difference was statistically significant (P<0.05).There was no significant difference in the levels of PCT and CRP between the sepsis group and the infection group (P>0.05).The PCIS score in the severe sepsis group was lower than that in the sepsis group,the PELOD-2 and PRISMIII scores were higher than those in the sepsis group,and the differences were statistically significant (P<0.05).Plasma mt-DNA was positively correlated with PCT,CRP,Lac,PELOD-2 and PRISMⅢ scores (r=0.877,0.904,0.875,0.923,0.870,all P=0.000).Plasma mt-DNA was negatively correlated with PCIS score (r=-0.841,P=0.000).The plasma levels of mt-DNA,PCT,CRP and Lac in the death group were higher than those in the survival group,and the differences were statistically significant (P<0.05).The ROC curve was established.When the cut-off of plasma mt-DNA,PCT,CRP,and Lac levels were 1124.28 pg/mL,18.49ng/mL,27.38mg/L,and 3.04 mmoL/L,Youden was the highest,with AUCs of 0.817 and 0.716,,0.607,0.759 respectively.The sensitivity of plasma mt-DNA in predicting the prognosis of sepsis was 80.95%,which was significantly higher than 71.43%,66.67% and 76.19% of PCT,CRP and Lac; the specificity of plasma mt-DNA in predicting the prognosis of sepsis was 93.90%.It was significantly higher than 81.71%,75.61% and 74.39% of PCT,CRP and Lac,and the differences were statistically significant (P<0.05). Conclusion: There are significant differences in mt-DNA in children with sepsis of different severity and prognosis.Plasma mt-DNA can be used as a biomarker for the early diagnosis of sepsis as it can help to assess the severity and prognosis of septic children.
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