Objective To investigate the predictive value of transmembrane protein 176B (TMEM176B) mRNA, interleukin-1β (IL-1β), interleukin-6 (IL-6) levels in peripheral blood mononuclear cells (PBMCs), and the sequential organ failure assessment (SOFA) score for the 28-day prognosis of patients with sepsis and septic shock.
Methods A total of 159 patients with sepsis and septic shock were retrospectively enrolled and divided into survival group (n=101) and non-survival group (n=58) based on their 28-day survival status. Clinical data were collected. TMEM176B mRNA expression in PBMCs was detected by real-time fluorescent quantitative polymerase chain reaction, while IL-1β and IL-6 levels were measured by enzyme-linked immunosorbent assay. The SOFA score was also evaluated. Pearson correlation analysis was used to explore the correlations of the SOFA score with TMEM176B mRNA, IL-1β, and IL-6 levels. Univariate and multivariate logistic regression analyses were performed to identify factors influencing 28-day mortality. Receiver operating characteristic (ROC) curves were plotted to assess the predictive efficacy of TMEM176B mRNA, IL-1β, IL-6, and the SOFA score for 28-day mortality.
Results The TMEM176B mRNA expression level was significantly lower in the non-survival group than in the survival group, whereas IL-1β and IL-6 levels and the SOFA score were significantly higher (all P < 0.05). Pearson correlation analysis revealed positive correlations of the SOFA score with IL-1β (r=0.469, P=0.010) and IL-6 (r=0.523, P=0.003) levels, and a negative correlation with TMEM176B mRNA level (r=-0.617, P < 0.001). Multivariate logistic regression analysis demonstrated that TMEM176B mRNA < 1.14, IL-1β≥2.39 pg/mL, IL-6>26.13 pg/mL, and a SOFA score>13.10 were independent risk factors for 28-day mortality in patients with sepsis and septic shock (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) for the combined prediction of 28-day mortality using peripheral blood TMEM176B mRNA, IL-1β, IL-6, and the SOFA score was 0.927, which was significantly higher than the AUC values for each individual marker (0.892, 0.739, 0.710 and 0.777, respectively; P < 0.001).
Conclusion In patients with sepsis and septic shock, TMEM176B mRNA expression in PBMCs is significantly decreased, while IL-1β and IL-6 levels and the SOFA score are significantly increased. The combined application of these four markers demonstrates high predictive efficacy for 28-day mortality and provides a reference for the early clinical identification of high-risk patients.
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