Evaluation of the prognostic value of GDF-15 combined with IL-6 in patients with sepsis

Wang Li

doi:10.3969/j.issn.1002-1949.2018.04.015

Abstract：Objective To evaluate the value of growth differentiation factor-15 (GDF-15) combined with interleukin-6 (IL-6) in predicting the adverse prognosis of sepsis.Methods From November 2016 to November 2017,79 patients with sepsis and 67 patients without sepsis were enrolled in our hospital.The differences of the indexes of PCT,CRP,IL-6,GDF-15,APACHE Ⅱ,SOFA between the two groups were compared,and the correlation between GDF-15 and organ failure biomarkers was analyzed.The values of GDF-15 with PCT,CRP,IL-6 and different combinations in judging the prognosis of sepsis were compared by using ROC curve.Results The indexes of PCT,CRP,IL-6,GDF-15,APACHE Ⅱ score and SOFA score were significantly different between the two groups (P ＜ 0.05).Correlation analysis showed that GDF-15 was significantly associated with markers of renal dysfunction such as creatinine and sCysC,markers of liver dysfunction such as bilirubin and albumin,prothrombin time,D2 aggregates,and NT-proBNP (P ＜ 0.05),and had positive correlation with disease severity score (P ＜0.001).Inflammation markers such as CRP,PCT,IL-6 were closely related (P ＜0.001).ROC analysis showed that the area under the curve (AUC) of IL-6 was 0.899 (95％ CI 0.825 ～0.984) with a sensitivity and specificity of 90％ and 89％,respectively,which were significantly higher than those of CRP,PCT and GDF-15 (P ＜ 0.001).The combined diagnosis showed that the AUC of IL-6,CRP and PCT combined with GDF-15 were significantly higher than that of single diagnosis (P ＜ 0.001),and the highest AUC of IL-6 and GDF-15 was 0.926 (0.874 ～0.981).The sensitivity and specificity were 91％ and 93 ％,respectively (P ＜ 0.001).Conclusion GDF-15 is associated with organ failure in sepsis.The combined detection of IL-6 and GDF-15 is highly sensitive and specific in assessing the prognosis of sepsis.