Changes in serum adiponectin levels in children with severe sepsis and its clinical significance

Abstract

Objective To study the changes in serum adiponectin level in children with severe sepsis, and to explore its clinical significance. Methods A prospective study was conducted, and 39 cases of critically ill children with severe sepsis and 47 cases of sepsis were enrolled into the Pediatric Intensive Care Unit(PICU), Children′s Hospital of Nanjing Medical University from July 2012 to July 2014.Thirty cases of critically ill children without sepsis were enrolled as a control group.The plasma adiponectin, procalcitonin (PCT), and C-reactive protein(CRP) were determined with enzyme linked immunosorbent assay (ELISA) within 24 hours after PICU admission.The pediatric critical illness score (PCIS) was recorded. Results Among severe sepsis group, sepsis group and control group, there was no statistical significance in body temperature, heart rate, body mass index, PCIS, white blood cell count, platelet count, bilirubin, creatinine, pH value and activated partial thromboplastin time(APTT) (all P>0.05). Plasma adiponectin in the severe sepsis group[(0.102±0.041) mg/L] significantly decreased compared with that in the sepsis group[(0.125±0.046) mg/L] and the control group[(0.147±0.047) mg/L](F=8.456, P=0.000). The level of CRP in the severe sepsis group[(60.68±59.43) mg/L] significantly increased compared with that in the sepsis group[(52.76±26.67) mg/L] and the control group[(33.89±6.87) mg/L] (F=17.416, P=0.000). There was a statistical significance in PCT level in the severe sepsis group, the sepsis group and the control group (χ2=27.269, P=0.000). Further comparison showed that there was a significant difference in PCT level between the severe sepsis group and the sepsis group (Z=-4.679, P=0.000), which was also statistically significant between the severe sepsis group and the control group (Z=-4.244, P=0.000); there was no significant difference between the sepsis group and the control group (Z=-0.340, P=0.733). Negative correlation was found between plasma adiponectin and CRP (r=-0.219, P=0.042), PCT (r=-0.303, P=0.005). The correlation between plasma adiponectin and PCIS was positively correlated (r=0.332, P=0.002). Conclusions Plasma adiponectin decreased in severe sepsis children and was significantly associated with the severity of the disease.Detection of plasma adiponectin levels in children with sepsis has an important clinical significance in evaluating the severity of sepsis.Plasma adiponectin is negatively correlated with CRP and PCT, and plays a role in diagnosis of infection. Key words: Adiponectin; Severe sepsis; Critical illness; Pediatric critical illness score