BACKGROUND We aimed to investigate the role of angiopoietin (Angpt) as a predictive biomarker for sepsis by evaluating associations between plasma Angpt and various inflammatory cytokines and mortality in critically ill patients with sepsis. METHODS This study was a retrospective cohort study of the prospectively collected samples and clinical data of 145 patients with sepsis who were admitted to the medical intensive care unit (ICU) of a 2000-bed university tertiary referral hospital in South Korea. We collected plasma within 24 h of medical ICU admission, and several biomarkers (Angpt-1 and -2, Tie2, vascular endothelial growth factor, interleukin (IL)-1β, IL-10, IL-18, IL-6, interferon gamma-induced protein-10, and tumor necrosis factor-α) were measured using a Human Magnetic Luminex Screening Assay kit. RESULTS Plasma Angpt-2 was correlated with IL-6 (rs = 0.555) and tumor necrosis factor-α (rs = 0.559). Plasma Angpt-2 (rs = 0.530) and Angpt-2/1 (rs = 0.562) were correlated with the Sequential Organ Failure Assessment (SOFA) score. The area under the curve (AUC) for the 28-day mortality prediction for the plasma Angpt-2/1 ratio was 0.736; AUCs for the Acute Physiology and Chronic Health Evaluation II (APACHE II) and SOFA scores were 0.659 and 0.745, respectively. Using multivariate Cox proportional hazard regression analysis for 28-day mortality, we found that acute respiratory distress syndrome (hazard ratio (HR) = 2.235, 95% CI = 1.163-4.296,p = 0.016), APACHE II score (HR = 1.127, 95% CI = 1.037-1.224,p = 0.005), and Angpt-2/1 > 3.2 (HR = 2.522, 95% CI = 1.205-5.278,p = 0.014) were risk factors for 28-day mortality. CONCLUSIONS Plasma Angpt-2 was related to cytokines, but Angpt-2/1 ratio was a good predictor of 28-day mortality in patients with sepsis.

中文翻译：

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血浆 angiopoietin-2 与 angiopoietin-1 的比率作为脓毒症患者的预后生物标志物

背景我们旨在通过评估血浆 Angpt 与各种炎性细胞因子和脓毒症重症患者死亡率之间的关联，研究血管生成素 (Angpt) 作为脓毒症预测生物标志物的作用。方法 本研究是一项回顾性队列研究，前瞻性地收集了 145 名入住韩国拥有 2000 个床位的大学三级转诊医院的重症监护病房 (ICU) 的脓毒症患者的样本和临床数据。我们在内科 ICU 入院 24 小时内收集血浆，以及几种生物标志物（Angpt-1 和 -2、Tie2、血管内皮生长因子、白细胞介素 (IL)-1β、IL-10、IL-18、IL-6、干扰素γ β-诱导蛋白-10 和肿瘤坏死因子-α) 使用 Human Magnetic Luminex Screening Assay 试剂盒进行测量。结果血浆Angpt-2与IL-6 (rs = 0.555)和肿瘤坏死因子-α (rs = 0.559)相关。血浆 Angpt-2 (rs = 0.530) 和 Angpt-2/1 (rs = 0.562) 与顺序器官衰竭评估 (SOFA) 评分相关。血浆 Angpt-2/1 比率的 28 天死亡率预测的曲线下面积 (AUC) 为 0.736；急性生理学和慢性健康评估 II (APACHE II) 和 SOFA 评分的 AUC 分别为 0.659 和 0.745。对 28 天死亡率使用多变量 Cox 比例风险回归分析，我们发现急性呼吸窘迫综合征（风险比 (HR) = 2.235，95% CI = 1.163-4.296，p = 0.016），APACHE II 评分（HR = 1.127， 95% CI = 1.037-1.224，p = 0.005）和 Angpt-2/1 > 3.2（HR = 2.522，95% CI = 1.205-5.278，p = 0.014）是 28 天死亡率的危险因素。