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Relationship Between Resistin Levels and Sepsis Among Children Under 12 Years of Age: A Case Control Study
Lida Saboktakin1, Nemat Bilan1, Afshin Ghalehgolab Behbahan1
1Pediatric Health Research Center, Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
Resistin levels can indicate sepsis in children admitted to the pediatric intensive care unit (PICU). This study found resistin levels increased in septic children, with a cut-off of 5.2 ng/ml showing high diagnostic accuracy.
Area of Science:
- Pediatric Intensive Care
- Infectious Diseases
- Biomarkers
Background:
- Sepsis is a life-threatening condition in children, necessitating early and accurate diagnosis.
- Resistin, a pro-inflammatory adipokine, has been implicated in inflammatory responses, but its role in pediatric sepsis requires further elucidation.
Purpose of the Study:
- To investigate resistin levels in children with sepsis in the pediatric intensive care unit (PICU).
- To compare resistin levels between septic children, non-septic PICU patients, and healthy children.
- To identify potential cut-off values of resistin for diagnosing pediatric sepsis.
Main Methods:
- A case-control study involving three groups: pediatric patients with sepsis, pediatric patients without sepsis, and healthy children.
- Measurement of serum resistin levels on days 1, 4, and 7 post-admission.
- Analysis of demographic, anthropometric, and clinical data.
Main Results:
- Resistin levels were significantly higher in the sepsis group compared to control groups on multiple days.
- A significant increasing trend of resistin levels was observed in septic children.
- Resistin demonstrated high diagnostic accuracy for sepsis, with a cut-off of 5.2 ng/ml showing 82.4% sensitivity and 72% specificity.
Conclusions:
- Serum resistin levels can serve as a valuable indicator for sepsis diagnosis in children within the PICU.
- The optimal cut-off value for resistin may vary depending on factors like the control group and the duration of illness.
Abstract:
Objective: The aim of this study was to investigate the level of resistin in children with and without sepsis hospitalized in the pediatric intensive care unit (PICU) and compare them to levels in healthy subjects in order to determine the trend of resistin levels in children in PICUs and also to identify the cut-off values for positive sepsis. Methods: This was a case-control study conducted in 2014 at a children's hospital in Tabriz, Iran. Three groups were investigated, a case group comprised of patients with sepsis admitted to PICU and two control groups; one made up of patients admitted to PICU without sepsis and the other of healthy children. Variables included demographic, anthropometric (growth metric percentile), and clinical factors. Results: Patients were randomized into control group A (n = 12, 48%), control group B (n = 11, 44%), and the sepsis group (n = 24, 47.1%). The difference in the means of resistin levels was significant on the first, fourth, and seventh days (P < 0.0001) in the case and control group A. Means comparisons in the case and control group B revealed significant differences on the fourth and seventh day (P = 0.005 and P < 0.0001, respectively) but not on the first day (P = 0.246). The trend of resistin levels increased in the septic group (F Huynh-Feldt = 37.83, P < 0.0001). The diagnostic accuracy of resistin level was high for discriminating sepsis (area under the receiver operating characteristic curve [AUC] 0.864 [SE = 0.41]). The sensitivity was 0.824 and specificity 0.72 with a cut-off point of 5.2 ng/ml on the first day. Conclusion: In the present study, resistin level can be used as an indicator of sepsis in children admitted to PICU. However, the cut-off point based upon when a prediction could be made is different and is dependent on a variety of factors, such as control group and number of days since the first signs of sepsis.
