학술논문

Apelin-13 as a Potential Biomarker in Critical Illness
Document Type
Clinical report
Source
Journal of Clinical Medicine. July 2023, Vol. 12 Issue 14
Subject
Analysis
Prognosis
Aldosterone -- Analysis
Medical research -- Analysis
Glucocorticoids -- Analysis
Medicine, Experimental -- Analysis
Corticosteroids -- Analysis
Language
English
ISSN
2077-0383
Abstract
Author(s): Marin Gergics [1,2]; Gréta Pham-Dobor [1,2]; Csilla Kurdi [2,3]; Gergely Montskó [2,3]; Krisztina Mihályi [4]; Gábor Bánfai [4]; Péter Kanizsai [4]; Tamás Kőszegi [2,3]; Emese Mezősi [1,2]; László Bajnok [...]
Background: The adrenocortical system and copeptin as prognostic markers were intensively investigated in critical illness. The potential predictive power of apelin-13 as a biomarker is largely unknown. We aimed to investigate the prognostic role of apelin-13 in relation to free cortisol, aldosterone, CRH, and copeptin in critically ill patients. Methods: In this prospective observational study, 124 critically ill patients (64 men, 60 women, median age: 70 (59–78) years) were consecutively enrolled at the time of admission. All routinely available clinical and laboratory parameters were evaluated and correlated to hormonal changes. Results: Serum apelin-13 was 1161 (617–2967) pg/mL in non-survivors vs. 2477 (800–3531) pg/mL in survivors (p = 0.054). The concentrations of apelin-13 and CRH had strong positive correlations (r = 0.685, p < 0.001) and were significantly higher in surviving non-septic patients (Apelin-13 (pg/mL): 2286 (790–3330) vs. 818 (574–2732) p < 0.05; CRH (pg/mL) 201 (84–317) vs. 89 (74–233) p < 0.05). Apelin-13 and free cortisol were independent determinants of survival in the multivariate Cox regression analysis, while copeptin, CRH, or aldosterone were not. Conclusions: Beyond free cortisol, serum apelin-13 may also help refine prognostic predictions in the early phase of critical illness, especially in non-septic patients.