Correlation between serum levels of MMP-13, VASH-1 and prognosis in patients with sepsis complicated with acute kidney injury

doi:10.11958/20230928

Abstract

Abstract:

Objective To investigate the relationship between serum matrix metalloproteinase-13 (MMP-13) and vashohibin-1 (VASH-1) levels and death within 28 days after admission in patients with sepsis complicated with acute kidney injury (AKI). Methods A total of 120 patients with sepsis complicated with AKI (the AKI group) and 117 patients with simple sepsis without complicated AKI (the non-AKI group) were selected, and 136 healthy subjects during the same period were selected as the control group. Basic data of all subjects were collected, and renal function was detected. Serum MMP-13 and VASH-1 levels were detected by enzyme-linked immunosorbent assay. The survival of patients with sepsis complicated with AKI within 28 days after admission was observed. Patients were divided into the survival group (83 cases) and the death group (37 cases). The basic information, renal function, serum MMP-13 and VASH-1 levels were compared between patients in the control group, the non-AKI group, the AKI group and patients in the AKI group with different prognosis. The correlation between serum MMP-13 and VASH-1 levels in patients with sepsis complicated with AKI was analyzed by Pearson method. Logistic regression analysis was used to analyze the factors affecting the death of patients with sepsis complicated with AKI within 28 days after admission. The predictive value of serum MMP-13 and VASH-1 to death within 28 days after admission in patients with sepsis complicated with AKI was analyzed by receiver operating characteristic (ROC) curve. Results Compared with the non-AKI group, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and sequential organ failure assessment (SOFA) score were significantly increased in the AKI group (P<0.05). Compared with the control group and the non-AKI group, serum creatinine (Scr) and blood urea nitrogen (BUN) levels were significantly increased in the AKI group (P<0.05). Compared with the control group, serum levels of MMP-13 and VASH-1 were increased successively in the non-AKI group and the AKI group (P<0.05). Serum MMP-13 and VASH-1 levels were positively correlated with sepsis patients complicated with AKI (r=0.650, P<0.05). Compared with the survival group, APACHE Ⅱ score, SOFA score, serum Scr, BUN, MMP-13 and VASH-1 levels were significantly increased in the death group (P<0.05). APACHE Ⅱ score, serum MMP-13 and VASH-1 levels were independent risk factors for the death in patients with sepsis complicated with AKI within 28 days after admission (P<0.05). The area under curve (AUC) of serum MMP-13, VASH-1 and their combination predict mortality within 28 days after admission in sepsis patients with AKI were 0.810, 0.837 and 0.903, respectively. The AUC predicted by the combination of MMP-13 and VASH-1 was significantly higher than that predicted by serum MMP-13 and VASH-1 alone (P<0.05). Conclusion Serum MMP-13 and VASH-1 levels are increased in patients with sepsis complicated with AKI, which could affect the prognosis of sepsis patients complicated with AKI, and have a high predictive value for death within 28 days after admission.

Key words: sepsis, acute kidney injury, matrix metalloproteinase-13, vashohibin-1, death within 28 days

CLC Number:

R459.7，R692

Figures/Tables 7

References 18

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组别	n		BMI/ （kg/m²）		高血压史（有/无）		糖尿病史（有/无）	血管活性药物使用（有/无）
对照组	136		22.61±2.17		—		—	—
非AKI组	117		22.74±2.32		32/85		23/94	49/68
AKI组	120		22.96±2.45		34/86		27/93	65/55
χ²或F			0.740		0.028		0.287	3.582
组别		APACHE Ⅱ评分/分		SOFA/分		Scr/ （μmol/L）			BUN/ （μmol/L）
对照组		—		—		76.18±9.02			5.99±0.83
非AKI组		20.15±3.08		8.58±1.59		78.81±10.69			6.08±0.92
AKI组		24.08±4.59		12.57±2.26		124.12±17.25^ab			8.28±2.17^ab
F或t		7.720^＊＊		15.683^＊＊		552.452^＊＊			101.412^＊＊

组别	n		BMI/ （kg/m²）		高血压史（有/无）		糖尿病史（有/无）	血管活性药物使用（有/无）
对照组	136		22.61±2.17		—		—	—
非AKI组	117		22.74±2.32		32/85		23/94	49/68
AKI组	120		22.96±2.45		34/86		27/93	65/55
χ²或F			0.740		0.028		0.287	3.582
组别		APACHE Ⅱ评分/分		SOFA/分		Scr/ （μmol/L）			BUN/ （μmol/L）
对照组		—		—		76.18±9.02			5.99±0.83
非AKI组		20.15±3.08		8.58±1.59		78.81±10.69			6.08±0.92
AKI组		24.08±4.59		12.57±2.26		124.12±17.25^ab			8.28±2.17^ab
F或t		7.720^＊＊		15.683^＊＊		552.452^＊＊			101.412^＊＊

组别	n	MMP-13	VASH-1
对照组	136	22.58±3.69	307.39±45.27
非AKI组	117	63.46±7.81^a	364.42±51.63^a
AKI组	120	94.76±12.22^ab	485.76±69.98^ab
F		2 330.340^＊＊	330.060^＊＊

组别	n	MMP-13	VASH-1
对照组	136	22.58±3.69	307.39±45.27
非AKI组	117	63.46±7.81^a	364.42±51.63^a
AKI组	120	94.76±12.22^ab	485.76±69.98^ab
F		2 330.340^＊＊	330.060^＊＊

组别	n	性别（男/女）	年龄/岁	BMI/ （kg/m²）	高血压史/ （有/无）	糖尿病史/（有/无）	血管活性药物使用/（有/无）	APACHE Ⅱ评分/分	SOFA/分	Scr/ （μmol/L）	BUN/ （μmol/L）
生存组	83	50/33	63.67±8.32	22.78±2.51	22/61	18/65	47/36	19.15±3.28	10.72±2.11	119.34±13.92	7.74±1.80
死亡组	37	22/15	64.68±9.26	23.36±2.32	12/25	9/28	18/19	35.14±7.53	16.72±2.60	134.84±24.72	9.49±3.00
χ²或t		0.007	0.593	1.196	0.443	0.102	0.656	16.251^＊＊	13.367^＊＊	4.376^＊＊	3.960^＊＊