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Assessment of serum proprotein convertase subtilisin/kexin type 9 in pediatric sepsis syndrome
Suzan Omar Mousa1, Mohamed Farouk Afifi2, Noha Anwar Hassuna3
1Pediatric Department, Minia University Children Hospital, Faculty of Medicine, Minia University, El-Minya, 61111, Egypt. suzanmousa@mu.edu.eg.
Insights
Serum Proprotein convertase subtilisin/kexin type 9 (PCSK9) levels are elevated in children with sepsis and severe sepsis. Higher PCSK9 indicates a worse prognosis and can predict hematological dysfunction, suggesting its use as a prognostic biomarker.
Area of Science:
- Biochemistry
- Pediatric Medicine
- Critical Care
Background:
- Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
- Proprotein convertase subtilisin/kexin type 9 (PCSK9) is an enzyme implicated in cholesterol metabolism.
- PCSK9 levels may change in response to the metabolic alterations seen in sepsis.
Purpose of the Study:
- To investigate the prognostic value of serum PCSK9 levels in pediatric patients diagnosed with sepsis and severe sepsis.
- To compare PCSK9 levels between sepsis patients, severe sepsis patients, and healthy controls.
- To explore the correlation between PCSK9 levels and clinical outcomes in children with sepsis.
Main Methods:
- A cohort of 60 children was studied, divided into sepsis (30) and severe sepsis (30) groups.
- A control group of 30 healthy children was included for comparison.
- Serum PCSK9, LDL-cholesterol, complete blood count, renal function, and liver function tests were analyzed.
Main Results:
- Serum PCSK9 and LDL-cholesterol levels were significantly higher in both sepsis groups compared to controls (p < 0.05).
- PCSK9 levels were elevated in severe sepsis compared to sepsis, and in non-survivors compared to survivors (p < 0.05).
- PCSK9 positively correlated with hospital stay in survivors (r=0.67, p=0.001) and predicted hematological dysfunction (adjusted B=-96.95, p=0.03).
Conclusions:
- Serum PCSK9 is a potential biomarker for predicting poor prognosis in pediatric sepsis.
- Elevated PCSK9 levels in children with sepsis are associated with disease severity and adverse outcomes.
- PCSK9 may play a role in the pathophysiology of sepsis-induced complications.
Abstract:
Sepsis is a life-threatening condition that arises when the body's response to infection causes injury to its tissues and organs. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is an enzyme released in response to the drop in cholesterol level occurring in sepsis. Our study aimed to evaluate the prognostic role of serum Proprotein convertase subtilisin/kexin type 9 (PCSK9) level in children with sepsis and severe sepsis. Sixty children were included in this study. They were divided into two groups: 30 children in the sepsis group and 30 in the severe sepsis group. Another 30 apparently healthy children were included as a control group. Blood samples were withdrawn from all included children for complete blood count (CBC), renal function tests (RFT), liver function tests (LFT), LDL-cholesterol (LDL-C), blood culture, and serum PCSK9. In this study, PCSK9 and LDL-C were higher in the two sepsis groups than in the control group (p < 0.05). They were also higher in the severe sepsis group than the sepsis group and in the non-survivors than in the survivors (p < 0.05). PCSK9 was positively correlated with length of hospital stay in surviving children (r = 0.67, p = 0.001) and had predicted significant hematological dysfunction (adjusted B = - 96.95, p = 0.03). In conclusion, the PCSK9 assay can be used as a biomarker for bad prognosis in children suffering from clinical sepsis.
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