The prognostic evaluation value of serum PDK4 and CHIT1 in neonatal early-onset sepsis

Li Qian; Ma Caiyan; Li Linlin; Wei Minchao; Ge Jianfang

doi:10.3969/j.issn.1671-6450.2025.06.014

Abstract：Objective To study the expression levels of serum pyruvate dehydrogenase kinase 4(PDK4)and chiti-nase 1(CHIT1)in neonatal early-onset sepsis(EOS),and to analyze their prognostic value for EOS.Methods From Febru-ary 2021 to February 2024,114 EOS children diagnosed and treated in NICU of Shanxi Children's Hospital(Shanxi Maternal and Child Health Hospital)were selected as EOS group.According to the prognosis,they were divided into poor prognosis subgroup(n=31)and good prognosis subgroup(n=83),and 100 healthy newborns in the same period were selected as healthy control group.Serum PDK4 and CHIT1 levels were detected by enzyme-linked immunosorbent assay;Pearson correla-tion analysis was used to analyze the correlation between serum PDK4,CHIT1 and clinical parameters in children with EOS;Multivariate Logistic regression analysis was used to analyze the factors affecting the prognosis of EOS children;The receiver operating characteristic curve was used to analyze the value of serum PDK4 and CHIT1 in the evaluation of EOS.Results The serum levels of PDK4 and CHIT1 in EOS group were higher than those in healthy control group(t=44.576,38.771,all P＜0.001).The levels of procalcitonin,respiratory distress syndrome,necrotizing enterocolitis,shock,serum PDK4 and CHIT1 in EOS children in the poor prognosis subgroup were higher than those in the good prognosis subgroup(t=10.229,42.970,14.742,15.754,20.405,12.158,all P＜0.001).Serum PDK4 and CHIT1 were positively correlated with white blood cell count,C-reactive protein and procalcitonin(r=0.667,0.702,0.723,0.766,0.669,0.758,all P＜0.001).Procalcitonin,respiratory distress syndrome,necrotizing enterocolitis,shock,serum PDK4 and CHIT1 were risk factors for poor prognosis in children with EOS[OR(95％CI)=1.594(1.252-2.028),1.465(1.214-1.769),1.384(1.088-1.761),1.323(1.124-1.557),1.589(1.258-2.006),1.733(1.249-2.404)].The AUC of serum PDK4,CHIT1 and the combination of the two in predicting the poor prognosis of EOS children were 0.836,0.825 and 0.926,respectively.The combination of the two was superior to their respective predictive val-ues(Z=4.560,4.563,P＜0.001).Conclusion The levels of serum PDK4 and CHIT1 in children with EOS are increased,which are related to the severity of the disease.The combination of the two has a high evaluation efficiency for the prognosis of chil-dren with EOS.