RT Journal Article
SR Electronic
T1 Free leptin index in critically ill septic patients: a prospective case-control study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2259
DO 10.1183/13993003.congress-2019.PA2259
VO 54
IS suppl 63
A1 Karampela, Irene
A1 Kandri, Evangelia
A1 Chrysanthopoulou, Evangelia
A1 Skyllas, George
A1 Christodoulatos, Gerasimos-Socrates
A1 Antonakos, Georgios
A1 Vogiatzakis, Evangelos
A1 Armaganidis, Apostolos
A1 Dalamaga, Maria
YR 2019
UL http://erj.ersjournals.com/content/54/suppl_63/PA2259.abstract
AB Introduction: Leptin, shown to be altered in sepsis, is found in serum as free or bound to its soluble receptor (sOB-R). Free leptin index (FLI), expressed as the ratio of total leptin to sOB-R, represents leptin resistance and has not been studied in sepsis.Aim: To investigate whether FLI and its kinetics early in sepsis predict severity and outcome.Methods: In a prospective case-control study, serum total leptin and sOB-R concentrations were determined by ELISA in 102 critically ill patients (57 males, mean age 65±15 years) at sepsis onset and one week after, and in 102 age and gender-matched healthy controls. FLI was calculated as total leptin/sOB-R.Results: Sixty patients presented with sepsis and 42 with septic shock. Mean APACHE II was 23±7. Mortality within 28 days was 29.4%. At admission, FLI was significantly higher in patients compared to controls (0.99±0.6 vs 0.69±0.9, p<0.01) while it significantly decreased one week after in all patients (0.99±0.6 vs 0.79±0.4, p<0.01). FLI did not differ between patients with sepsis and septic shock either at baseline or day 7. However, FLI was higher in survivors than nonsurvivors at baseline (1.11±0.6 vs 0.7±0.2, p<0.001) and day 7 (0.88±0.5 vs 0.59±0.2, p<0.001) showing a higher percentage decrease at day 7 in survivors (20±5% vs 16±3%, p<0.001). Baseline FLI exhibited significant positive correlations with APACHE II. In univariate Cox regression analysis, FLI at days 1 and 7 was not a significant prognostic factor for sepsis outcome, but higher FLI kinetics (absolute decrease at day 7 compared to baseline) was found to predict survival (HR 0.86, 95%CI 0.753-0.984, p=0.028).Conclusion: FLI kinetics early in sepsis may be a prognostic biomarker.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2259.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).