Correlation between serum METTL14,RIPK1,and the severity and prognosis of patients with sepsis-associated ARDS

Ma Yuhong; Yang Hongnian; Shang Yaru; Yin Tao; Yang Dong; Chen Mengfei

doi:10.3969/j.issn.1671-6450.2025.07.003

Abstract：Objective To analyze the correlation between serum methyltransferase-like protein 14(METTL14),re-ceptor-interacting protein kinase 1(RIPK1)levels,disease severity,and prognosis in patients with sepsis-associated acute re-spiratory distress syndrome(S-ARDS).Methods A total of 182 S-ARDS patients admitted to the Emergency Department of Ningxia People's Hospital from January 2021 to August 2024 were selected as the S-ARDS group,along with 182 healthy volunteers matched at a 1∶1 ratio as the healthy control group.According to the severity of the disease(oxygenation index)and 28-day prognosis,S-ARDS patients were further divided into mild S-ARDS group(48 cases),moderate S-ARDS group(66 cases),severe S-ARDS group(68 cases),survival group,and death group.Serum METTL14 levels were measured by en-zyme-linked immunosorbent assay.The correlation between serum METTL14,RIPK1 levels,and the oxygenation index of S-ARDS patients was analyzed using Pearson correlation analysis.Multivariate logistic regression,receiver operating characteris-tic(ROC)curve,and decision curve analysis(DCA)were used to assess the relationship,predictive value,and clinical benefit of serum METTL14 and RIPK1 levels for the prognosis of S-ARDS patients.Results Serum METTL14 and RIPK1 levels in the S-ARDS group were significantly higher than those in the healthy control group(t/P=20.742/＜0.001,17.877/＜0.001).Ser-um METTL14 and RIPK1 levels increased gradually with the severity of S-ARDS in the mild,moderate,and severe S-ARDS groups(F/P=310.610/＜0.001,362.391/＜0.001),and both were positively correlated with the oxygenation index(r/P=0.723/＜0.001,0.742/＜0.001).The 28-day mortality rate of 182 S-ARDS patients was 33.52％(61/182).Oxygenation index was an in-dependent protective factor for mortality in S-ARDS patients,while mechanical ventilation time,sequential organ failure as-sessment(SOFA)score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,METTL14,and RIPK1 were independent risk factors[OR(95％CI)=7.438(1.980-27.944),1.416(1.100-1.821),1.207(1.098-1.327),1.513(1.177-1.946),2.336(1.635-3.336),0.976(0.965-0.988)].The AUC of serum METTL14,RIPK1,and their combination in predicting mortality in S-ARDS patients was 0.771,0.780,and 0.867,respectively,with a significantly larger AUC in the combined prediction model(Z/P=3.397/＜0.001,3.198/＜0.001).DCA showed that the combined prediction of METTL14 and RIPK1 had higher net benefit rates than the individual indicators within the threshold probability range of 0.20-0.95.Conclusion Elevated serum METTL14 and RIPK1 levels are closely associated with disease severity and mortality in S-ARDS patients.The combined pre-diction model based on serum METTL14 and RIPK1 levels provides higher predictive value and net clinical benefit for S-ARDS patient mortality.