中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 12
Dec.  2023
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(12): 2867-2872

Value of the serum levels of Clusterin and sphingosine 1-phosphate in assessing the prognosis of sepsis patients with acute liver injury

DOI: 10.3969/j.issn.1001-5256.2023.12.018

  • Department of Gastroenterology，Lianyungang Hospital，Xuzhou Medical University，Lianyungang，Jiangsu 222000，China

Research funding:

Health Research Project of Lianyungang city in Jiangsu Province (ZD1903)

More Information
  • Corresponding author: ZHANG Zhimei， 1365360153@qq.com （ORCID： 0009-0002-8793-1432）
  • Received Date: 2023-07-21
  • Accepted Date: 2023-08-23
  • Published Date: 2023-12-12
    Abstract
  •   Objective  To investigate the value of the serum levels of Clusterin and sphingosine 1-phosphate （S1P） in assessing the prognosis of sepsis patients with acute liver injury.  Methods  A total of 127 sepsis patients with acute liver injury who were admitted to Lianyungang Hospital， Xuzhou Medical University， from March 2019 to May 2022 were enrolled， and according to their prognosis after 28 days of treatment， they were divided into death group with 35 patients and survival group with 92 patients. The independent-samples t test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between groups. A pearson correlation analysis was used to investigate the correlation. The prognostic value of serum Clusterin and S1P was analyzed by receiver operating characteristic curve.  Results  There were significant differences between the two groups in the degree of liver injury， Acute Physiology and Chronic Health Evaluation Ⅱ （APACHEⅡ） score， Sequential Organ Failure Assessment （SOFA） score， the presence or absence of acute kidney injury， prothrombin time （PT）， international normalized ratio （INR）， Child-Pugh class， and C-reactive protein （all P<0.05）. The death group had significantly lower serum levels of Clusterin and S1P than the survival group （t=11.094 and 10.390， both P<0.05）. The patients with severe liver injury had significantly lower serum levels of Clusterin and S1P than those with mild or moderate liver injury （t=9.825 and 11.418， both P<0.05）. The multivariate regression analysis showed that the degree of liver injury （odds ratio ［OR］=1.260， 95% confidence interval ［CI］： 1.081 — 1.468， P<0.05）， APACHEII score （OR=1.031， 95%CI： 1.019 — 1.044， P<0.05）， SOFA score （OR=1.066， 95%CI： 1.039 — 1.094， P<0.05）， Clusterin （OR=0.899， 95%CI： 0.859 — 0.940， P<0.05）， and S1P （OR=0.824， 95%CI： 0.749 — 0.908， P<0.05） were independent risk factors for the prognosis of patients with sepsis. The ROC curve analysis showed that serum Clusterin and S1P used alone or in combination had an area under the ROC curve of 0.864， 0.861， and 0.949， respectively. Serum Clusterin and S1P were significantly negatively correlated with alanine aminotransferase， total bilirubin， PT， and INR in sepsis patients with acute liver injury （all P<0.05）.  Conclusion  The sepsis patients with acute liver injury who died had significant reductions in serum Clusterin and S1P compared with those who survived， and the levels of Clusterin and S1P are closely associated with the degree of liver injury. The combination of Clusterin and S1P has a good value in predicting the prognosis of sepsis patients with acute liver injury and is expected to become a potential marker for predicting the prognosis of sepsis patients with acute liver injury.

     

    • FullText(HTML)
  • loading
    • References(24)
  • [1]
    CAO C, YU MM, CHAI YF. Pathological alteration and therapeutic implications of sepsis-induced immune cell apoptosis[J]. Cell Death Dis, 2019, 10( 10): 782. DOI: 10.1038/s41419-019-2015-1.
    [2]
    HWANG JS, KIM KH, PARK J, et al. Glucosamine improves survival in a mouse model of sepsis and attenuates sepsis-induced lung injury and inflammation[J]. J Biol Chem, 2019, 294( 2): 608- 622. DOI: 10.1074/jbc.RA118.004638.
    [3]
    MA WK, YANG WG, LIN YH, et al. Predictive efficiency of miR-122a expression and HMGB1 level in serum on prognosis of children with SALI[J]. Shandong Med J, 2021, 61( 18): 20- 24. DOI: 10.3969/j.issn.1002-266X.2021.18.005.

    马伟科, 杨卫国, 林燕鸿, 等. 血清miR-122a表达、HMGB1水平对脓毒症并发肝损伤患儿预后的预测效能[J]. 山东医药, 2021, 61( 18): 20- 24. DOI: 10.3969/j.issn.1002-266X.2021.18.005.
    [4]
    GAO G, LUAN X. Diagnostic performance of clusterin in hepatocellular carcinoma: A meta-analysis[J]. Int J Biol Markers, 2022, 37( 4): 404- 411. DOI: 10.1177/03936155221101206.
    [5]
    SHAASHUA L, BEN-SHMUEL A, PEVSNER-FISCHER M, et al. BRCA mutational status shapes the stromal microenvironment of pancreatic cancer linking clusterin expression in cancer associated fibroblasts with HSF1 signaling[J]. Nat Commun, 2022, 13( 1): 6513. DOI: 10.1038/s41467-022-34081-3.
    [6]
    DENG Y, WANG RY. Changes in serum clusterin, S1P levels in patients with HBV associated with acute liver failure and their clinical significances[J]. Labeled Immunoass Clin Med, 2021, 28( 9): 1564- 1567, 1613. DOI: 10.11748/bjmy.issn.1006-1703.2021.09.024.

    邓盈, 王若宇. HBV相关慢加急性肝衰竭患者血清Clusterin、S1P水平变化及临床意义[J]. 标记免疫分析与临床, 2021, 28( 9): 1564- 1567, 1613. DOI: 10.11748/bjmy.issn.1006-1703.2021.09.024.
    [7]
    SHEN YF, ZHAO SJ, WANG SY, et al. S1P/S1PR3 axis promotes aerobic glycolysis by YAP/c-MYC/PGAM1 axis in osteosarcoma[J]. EBioMedicine, 2019, 40: 210- 223. DOI: 10.1016/j.ebiom.2018.12.038.
    [8]
    JIANG LB, LI RJ, ZHANG B, et al. 2016 international guidelines for management of sepsis and septic shock[J]. Chin J Emerg Med, 2017, 26( 3): 263- 266. DOI: 10.3760/cma.j.issn.1671-0282.2017.03.004.

    江利冰, 李瑞杰, 张斌, 等. 2016年脓毒症与脓毒性休克处理国际指南[J]. 中华急诊医学杂志, 2017, 26( 3): 263- 266. DOI: 10.3760/cma.j.issn.1671-0282.2017.03.004.
    [9]
    Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2018)[J]. J Clin Hepatol, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.

    中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2018年版)[J]. 临床肝胆病杂志, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.
    [10]
    ARORA V, MAIWALL R, RAJAN V, et al. Terlipressin is superior to noradrenaline in the management of acute kidney injury in acute on chronic liver failure[J]. Hepatology, 2020, 71( 2): 600- 610. DOI: 10.1002/hep.30208.
    [11]
    CHEN C, CUI J, JI XQ, et al. Analysis of prognostic risk factors in patients with sepsis[J]. Clin J Med Offic, 2021, 49( 1): 61- 63. DOI: 10.16680/j.1671-3826.2021.01.18.

    陈城, 崔静, 纪小奇, 等. 脓毒症患者预后危险因素分析[J]. 临床军医杂志, 2021, 49( 1): 61- 63. DOI: 10.16680/j.1671-3826.2021.01.18.
    [12]
    WANG FC, ZHANG WJ, LI ZY, et al. Value of Charlson comorbidity index in predicting the prognosis of patients with acute-on-chronic liver failure[J]. J Clin Hepatol, 2023, 39( 5): 1098- 1104. DOI: 10.3969/j.issn.1001-5256.2023.05.015.

    王富春, 张万洁, 李子怡, 等. 查尔森共病指数对慢加急性肝衰竭患者预后的评估价值[J]. 临床肝胆病杂志, 2023, 39( 5): 1098- 1104. DOI: 10.3969/j.issn.1001-5256.2023.05.015.
    [13]
    WANG H, ZHANG X, XUE QL, et al. Effects and mechanism of seabuckthorn polysaccharide on sepsis induced liver injury based on liver specific PPARγ knockout mice[J]. Chin J Immunol, 2022, 38( 7): 789- 794. DOI: 10.3969/j.issn.1000-484X.2022.07.004.

    王慧, 张鑫, 薛乾隆, 等. 基于肝脏特异性PPARγ敲除小鼠研究沙棘多糖减轻脓毒症诱导肝损伤的作用及机制[J]. 中国免疫学杂志, 2022, 38( 7): 789- 794. DOI: 10.3969/j.issn.1000-484X.2022.07.004.
    [14]
    TRIANTAFYLLOU E, GUDD CL, MAWHIN MA, et al. PD-1 blockade improves Kupffer cell bacterial clearance in acute liver injury[J]. J Clin Invest, 2021, 131( 4): e140196. DOI: 10.1172/JCI140196.
    [15]
    DAI JM, GUO WN, TAN YZ, et al. Wogonin alleviates liver injury in sepsis through Nrf2-mediated NF-κB signalling suppression[J]. J Cell Mol Med, 2021, 25( 12): 5782- 5798. DOI: 10.1111/jcmm.16604.
    [16]
    SUN YB, TENG SY, LUO ZL, et al. Predictive value of serum Clusterin for major adverse cardiovascular events after PCI in patients with acute STEMI[J]. Chin J Evid Bases Cardiovasc Med, 2022, 14( 8): 1008- 1011. DOI: 10.3969/j.issn.1674-4055.2022.08.28.

    孙彦博, 滕思勇, 罗振立, 等. 血清Clusterin对急性STEMI患者PCI术后主要不良心血管事件的预测价值[J]. 中国循证心血管医学杂志, 2022, 14( 8): 1008- 1011. DOI: 10.3969/j.issn.1674-4055.2022.08.28.
    [17]
    WANG YS, SHEN Y, HU TT, et al. Associations between serum clusterin levels and non-alcoholic fatty liver disease[J]. Endocr Connect, 2023, 12( 7): e220545. DOI: 10.1530/EC-22-0545.
    [18]
    UDOMSINPRASERT W, POOVORAWAN Y, CHONGSRISAWAT V, et al. Decreased circulating clusterin reflects severe liver complications after hepatoportoenterostomy of biliary atresia[J]. Sci Rep, 2020, 10( 1): 19736. DOI: 10.1038/s41598-020-76875-9.
    [19]
    BRADLEY D, BLASZCZAK A, YIN Z, et al. Clusterin impairs hepatic insulin sensitivity and adipocyte clusterin associates with cardiometabolic risk[J]. Diabetes Care, 2019, 42( 3): 466- 475. DOI: 10.2337/dc18-0870.
    [20]
    PARK JS, LEE WK, KIM HS, et al. Clusterin overexpression protects against western diet-induced obesity and NAFLD[J]. Sci Rep, 2020, 10( 1): 17484. DOI: 10.1038/s41598-020-73927-y.
    [21]
    SEO HY, LEE SH, LEE JH, et al. Clusterin attenuates hepatic fibrosis by inhibiting hepatic stellate cell activation and downregulating the Smad3 signaling pathway[J]. Cells, 2019, 8( 11): 1442. DOI: 10.3390/cells8111442.
    [22]
    SONG YX, WANG DX, WANG Y, et al. Relationship between serum S1P, SFRP1, TIM4 and SFRP5 and lung function, airway inflammation and acute recurrence after treatment in adult patients with acute attack stage of bronchial asthma[J]. Prog Mod Biomed, 2022, 22( 8): 1519- 1523. DOI: 10.13241/j.cnki.pmb.2022.08.025.

    宋云熙, 王东霞, 王英, 等. 血清S1P、SFRP1、TIM4、SFRP5与成人支气管哮喘急性发作期患者肺功能、气道炎症和治疗后再次急性复发的关系[J]. 现代生物医学进展, 2022, 22( 8): 1519- 1523. DOI: 10.13241/j.cnki.pmb.2022.08.025.
    [23]
    KAWAI H, OSAWA Y, MATSUDA M, et al. Sphingosine-1-phosphate promotes tumor development and liver fibrosis in mouse model of congestive hepatopathy[J]. Hepatology, 2022, 76( 1): 112- 125. DOI: 10.1002/hep.32256.
    [24]
    KIM JY, GARCIA-CARBONELL R, YAMACHIKA S, et al. ER stress drives lipogenesis and steatohepatitis via caspase-2 activation of S1P[J]. Cell, 2018, 175( 1): 133- 145.e15. DOI: 10.1016/j.cell.2018.08.020.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(6)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (289) PDF downloads(23) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return