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Discrimination of sepsis stage metabolic profiles with an LC/MS-MS-based metabolomics approach
  1. Longxiang Su1,2,
  2. Yingyu Huang3,
  3. Ying Zhu3,
  4. Lei Xia4,
  5. Rentao Wang1,
  6. Kun Xiao1,
  7. Huijuan Wang1,
  8. Peng Yan1,
  9. Bo Wen3,
  10. Lichao Cao3,
  11. Nan Meng3,
  12. Hemi Luan3,
  13. Changting Liu5,
  14. Xin Li6 and
  15. Lixin Xie1
  1. 1Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, China
  2. 2Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
  3. 3Shenzhen Proteome Engineering Laboratory, BGI Shenzhen, Shenzhen, China
  4. 4Decision-Consulting Office, Chinese PLA General Hospital, Beijing, China
  5. 5Nanlou Respiratory Diseases Department, Chinese PLA General Hospital, Beijing, China
  6. 6Clinical division of Internal Medicine, Chinese PLA General Hospital, Beijing, China
  1. Correspondence to Dr Lixin Xie; xielx{at}263.net Xin Li; lixin301@sina.com

Abstract

Background To identify metabolic biomarkers that can be used to differentiate sepsis from systemic inflammatory response syndrome (SIRS), assess severity and predict outcomes.

Methods 65 patients were involved in this study, including 35 patients with sepsis, 15 patients with SIRS and 15 normal patients. Small metabolites that were present in patient serum samples were measured by liquid chromatography mass spectrometry techniques and analysed using multivariate statistical methods.

Results The metabolic profiling of normal patients and patients with SIRS or sepsis was markedly different. A significant decrease in the levels of lactitol dehydrate and S-phenyl-d-cysteine and an increase in the levels of S-(3-methylbutanoyl)-dihydrolipoamide-E and N-nonanoyl glycine were observed in patients with sepsis in comparison to patients with SIRS (p<0.05). Patients with severe sepsis and septic shock displayed lower levels of glyceryl-phosphoryl-ethanolamine, Ne, Ne dimethyllysine, phenylacetamide and d-cysteine (p<0.05) in their sera. The profiles of patients with sepsis 48 h before death illustrated an obvious state of metabolic disorder, such that S-(3-methylbutanoyl)-dihydrolipoamide-E, phosphatidylglycerol (22:2 (13Z, 16Z)/0:0), glycerophosphocholine and S-succinyl glutathione were significantly decreased (p<0.05). The receiver operating characteristic curve of the differential expression of these metabolites was also performed.

Conclusions The body produces significant evidence of metabolic disorder during SIRS or sepsis. Seven metabolites may potentially be used to diagnose sepsis.

Trial registration number ClinicalTrial.gov identifier NCT01649440.

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