Serum Neopterin and its Significance as Biomarker in Differentiation of Mods From Sepsis

Abstract

Abstract Objective The aim of this study was to evaluate the dynamic changes of serum neopterin and its significance as biomarker in differentiation of MODS from sepsis. Methods Fifty eight critical illness patients and 21 healthy controls were included in the study. Of the included 58 critical illness patients, 37 cases were diagnosed of sepsis (sepsis group) and other 21 were non-sepsis subjects (non-sepsis group). Of the 37 sepsis patients, 17 were diagnosed of multiple organ dysfunction syndrome (MODS group). The serum level of neopterin of the above subjects were examined by enzyme linked immunosorbent assay and compared between groups. Results The serum level of neopterin were 0.885±0.34(ng/mL), 3.77±2.08(ng/mL), 14.80±6.78(ng/mL) and 23.90±11.26(ng/mL) for healthy control, non-sepsis, non-MODS and MODS groups respectively with significant statistical difference (F=52.71, p<0.001). Serum neopterin level of non-sepsis, non-MODS and MODS groups were statistical different in the time points of 0, 24h, 48h, 72h, and 96h (p<0.05). The serum neopterin level was significant higher in MODS group compared to nonsepsis and non-MODS groups (p<0.05). Using the serum neopterin as biomarker in differentiation of MODS from sepsis, the diagnostic sensitivity, specificity and AUC were 70.59% (95%CI:44.04-89.69) %, 80.00% (95%CI:56.34- 94.27)% and 0.74(95%CI:0.57-0.91)% respectively. Conclusion Serum neopterin levels in patients with sepsis were elevated and can be used as a promising biomarker in differentiation of MODS from sepsis.