Evaluation of the value of serum SGK1 and Metrnl levels in assessing disease severity and prognosis in sepsis patients

Zou Jiajun; Guo Jian; Xia Yichun; Qian Yiming

doi:10.3969/j.issn.1671-6450.2025.04.001

Abstract：Objective To investigate the value of serum serum/glucocorticoid-regulated kinase 1(SGK1)and mete-orin-like(Metrnl)levels in assessing the severity and prognosis of sepsis patients.Methods A total of 90 sepsis patients admitted to the Emergency Medicine Department of Yueyang Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,from January 2022 to May 2024 were enrolled as the ob-servation group.Based on disease severity,patients were divided into the general sepsis subgroup(68 cases)and the septic shock subgroup(22 cases).According to the 28-day prognosis,they were further divided into the death subgroup(25 ca-ses)and survival subgroup(65 cases).Additionally,30 healthy volunteers from the hospital's health checkup program dur-ing the same period were included as the healthy control group.Serum SGK1 and Metrnl levels were measured by enzyme-linked immunosorbent assay.The correlation between serum SGK1,Metrnl levels,and disease severity in sepsis patients was analyzed using Pearson correlation.Multivariate logistic regression was used to determine the effect of serum SGK1 and Metml levels on sepsis prognosis.Receiver operating characteristic(ROC)curves were constructed to evaluate the predic-tive performance of serum SGK1 and Metrnl levels for sepsis mortality prognosis.Results Serum SGK1 levels in the obser-vation group were lower than those in the healthy control group,while serum Metrnl levels were higher(t/P=8.394/＜0.001,10.994/＜0.001).Serum SGK1 levels in the septic shock subgroup were lower than those in the general sepsis subgroup,while Metrnl levels were higher(t/P=4.444/＜0.001,4.493/＜0.001).The severity of sepsis was negatively correlated with se-rum SGK1 levels and positively correlated with Metrnl levels(r/P=-0.677/＜0.001,0.685/＜0.001).In the death subgroup,the proportions of septic shock and mechanical ventilation ≥3 days,Sequential Organ Failure Assessment(SOFA)scores,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores,and serum Metrnl levels were higher than in the survival subgroup.Conversely,the oxygenation index and serum SGK1 levels were lower(x2/t/P=10.399/0.001,7.123/0.008,3208/0.003,4.234/＜0.001,4.634/＜0.001,4.156/＜0.001,4.578/＜0.001).Multivariate logistic regression analysis showed that elevated serum Metrnl levels were an independent risk factor for sepsis mortality[OR(95％CI)=1.028(1.008-1.049)],while elevated serum SGK1 levels were an independent protective factor[OR(95％CI)=0.614(0.421-0.896)].The area under the curve(AUC)for predicting sepsis mortality using serum SGK1,Metrnl levels,and their combination was 0.791,0.783,and 0.886,respectively,with the combined AUC being significantly greater than either alone(Z/P=2.122/0.034,2.382/0.017).Con-clusion Serum SGK1 levels decrease while Metrnl levels increase in sepsis patients,both of which are associated with greater disease severity and mortality.Combined detection of serum SGK1 and Metrnl levels has good predictive perform-ance for the prognosis of sepsis patients.