• Longxiang Su, Yingyu Huang, Ying Zhu, Lei Xia, Rentao Wang, Kun Xiao, Huijuan Wang, Peng Yan, Bo Wen, Lichao Cao, Nan Meng, Hemi Luan, Changting Liu, Xin Li, and Lixin Xie.
• Department of Respiratory Medicine , Chinese PLA General Hospital , Beijing , China ; Department of Critical Care Medicine , Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences , Beijing , China.
• BMJ Open Respir Res. 2014 Jan 1; 1 (1): e000056.

BackgroundTo identify metabolic biomarkers that can be used to differentiate sepsis from systemic inflammatory response syndrome (SIRS), assess severity and predict outcomes.Methods65 patients were involved in this study, including 35 patients with sepsis, 15 patients with SIRS and 15 normal patients. Small metabolites that were present in patient serum samples were measured by liquid chromatography mass spectrometry techniques and analysed using multivariate statistical methods.ResultsThe metabolic profiling of normal patients and patients with SIRS or sepsis was markedly different. A significant decrease in the levels of lactitol dehydrate and S-phenyl-d-cysteine and an increase in the levels of S-(3-methylbutanoyl)-dihydrolipoamide-E and N-nonanoyl glycine were observed in patients with sepsis in comparison to patients with SIRS (p<0.05). Patients with severe sepsis and septic shock displayed lower levels of glyceryl-phosphoryl-ethanolamine, Ne, Ne dimethyllysine, phenylacetamide and d-cysteine (p<0.05) in their sera. The profiles of patients with sepsis 48 h before death illustrated an obvious state of metabolic disorder, such that S-(3-methylbutanoyl)-dihydrolipoamide-E, phosphatidylglycerol (22:2 (13Z, 16Z)/0:0), glycerophosphocholine and S-succinyl glutathione were significantly decreased (p<0.05). The receiver operating characteristic curve of the differential expression of these metabolites was also performed.ConclusionsThe body produces significant evidence of metabolic disorder during SIRS or sepsis. Seven metabolites may potentially be used to diagnose sepsis.Trial Registration NumberClinicalTrial.gov identifier NCT01649440.

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