α-1-Acid glycoprotein as a biomarker for the early diagnosis and monitoring the prognosis of sepsis

J Crit Care. 2015 Aug;30(4):744-51. doi: 10.1016/j.jcrc.2015.04.007. Epub 2015 Apr 17.

Abstract

Objective: To explore the value of α-1-acid glycoprotein (AGP) for the early diagnostic and prognostic assessment of patients with sepsis.

Methods: Eighty-five patients with systemic inflammatory response syndrome (SIRS) and 192 patients with sepsis were enrolled. White blood cell counts and serum levels of AGP, C-reactive protein, and procalcitonin were tested on the day of admission to intensive care unit (ICU; day 1) and the following days 3, 5, 7, and 10.

Results: The sepsis group exhibited significantly higher levels of AGP than did the SIRS group on day 1 (P < .05); the area under the curve (AUC) of AGP was 0.869 with a specificity of 0.902 on diagnosis of sepsis. The differences were statistically significant among sepsis subgroups. On prognostic assessment, the areas under the curve of AGP, Sequential Organ Failure Assessment (SOFA) scores, and SOFA + AGP on ICU admission were 0.793, 0.813, and 0.878, respectively. The results of logistic regression showed that the odds ratios of AGP, SOFA, Acute Physiology and Chronic Health Evaluation II, and the length of ICU stay were 1.450, 1.212, 1.673, and 1.130.

Conclusions: α-1-Acid glycoprotein could distinguish sepsis from SIRS and also be used to effectively assess the severity of sepsis. In addition, combined AGP and SOFA scores had a great predicting value in prognosis of sepsis.

Trial registration: ClinicalTrials.gov NCT01838525.

Keywords: Biomarker; Diagnosis; Prognosis; Sepsis; Severity; α-1-Acid glycoprotein (AGP).

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • APACHE
  • Adult
  • Aged
  • Area Under Curve
  • Biomarkers / blood*
  • Calcitonin
  • Calcitonin Gene-Related Peptide
  • China
  • Early Diagnosis
  • Female
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Leukocyte Count
  • Logistic Models
  • Male
  • Middle Aged
  • Organ Dysfunction Scores
  • Orosomucoid / metabolism*
  • Prognosis
  • Prospective Studies
  • Protein Precursors
  • Sensitivity and Specificity
  • Sepsis / blood
  • Sepsis / diagnosis*
  • Sepsis / mortality
  • Systemic Inflammatory Response Syndrome / blood
  • Systemic Inflammatory Response Syndrome / diagnosis*
  • Systemic Inflammatory Response Syndrome / mortality

Substances

  • Biomarkers
  • CALCA protein, human
  • Orosomucoid
  • Protein Precursors
  • Calcitonin
  • Calcitonin Gene-Related Peptide

Associated data

  • ClinicalTrials.gov/NCT01838525