Utility of Plasma Myostatin as a Predictive Biomarker for Post Intensive Care Syndrome in Patients With Sepsis

Post intensive care syndrome (PICS) is a critical issue in postsepsis care; however, no reliable biomarker exists to predict PICS. We hypothesized that plasma myostatin, a cytokine involved in muscle and brain function, could serve as a predictive biomarker for PICS.

This single-center prospective observational study included adult patients with sepsis admitted to the intensive care unit (ICU). Plasma myostatin concentrations were measured using enzyme-linked immunosorbent assay on days 1, 3-4, and 6-7 after sepsis diagnosis and ICU admission. PICS was assessed 6 months post-ICU discharge via telephone interviews using the Barthel Index, Short-Memory Questionnaire score, and Hospital Anxiety and Depression Scale. Multivariable logistic regression analysis was conducted to determine whether myostatin levels independently predicted PICS. Predictive performance was evaluated using the area under the curve (AUC).

Seventy-seven patients were enrolled (mean age: 71 ± 14 years; median SOFA score 7 [IQR: 6-11]). Plasma myostatin concentrations were 544 (311-1015) pg/mL on day 1, 495 (302-651) pg/mL on days 3-4, and 536 (385-817) pg/mL on days 6-7. Decreased plasma myostatin levels on day 1 and on days 6-7 contributed to identifying patients with cognitive and physical impairments, respectively (p = 0.04). A decreased plasma myostatin level on day 1 yielded an AUC of 0.70 for predicting cognitive impairment, whereas the day 6-7 level yielded an AUC of 0.76 for predicting physical impairment.

Lower plasma myostatin concentrations in the acute phase of sepsis may serve as a biomarker for predicting PICS-related physical and cognitive impairments.