Homocysteine and mortality in sepsis: a promising predictive biomarker?

Infectiology

Sepsis is an acute inflammatory response to infection, often associated with high mortality despite advances in intensive care. Identifying reliable predictive biomarkers is therefore essential to improve patient management and reduce mortality. Among the biomarkers explored, homocysteine (Hcy) appears to be a potential indicator, due to its role in oxidative stress, endothelial dysfunction and inflammation, essential mechanisms in the pathophysiology of sepsis. This study explores the association between Hcy levels and short-term mortality in patients with sepsis.

Can homocysteine levels predict short-term mortality in patients with sepsis?

The researchers included nine cohort studies involving a total of 771 adult patients with sepsis. Hcy levels were measured within 4 to 48 hours of diagnosis, with a 30-day follow-up to assess mortality. Random-effects models were used to calculate standardised mean differences (SMD) and odds ratios (OR) to assess the association between Hcy levels and mortality. A subgroup analysis was also performed according to ethnic origin (Asian vs non-Asian).

The results showed no significant association between Hcy levels and short-term mortality in patients with sepsis. However, subgroup analysis revealed a significant association between elevated Hcy levels and an increased risk of mortality in Chinese patients with sepsis. The absence of a significant correlation between Hcy levels and mortality in non-Asian patients suggests an ethical influence between the relationship between Hcy and mortality in sepsis.

Homocysteine, a new biomarker for predicting mortality in sepsis

Although the study did not confirm the general usefulness of Hcy as a biomarker of mortality in sepsis, it does highlight its potential as a prognostic marker for certain populations, particularly Asian patients. Further research is needed to better understand these ethnic differences and to assess whether Hcy could become a personalised biomarker for predicting mortality in specific populations.

Source(s) :
Lu, X., et al. (2024). The association of plasma homocysteine levels with short-term mortality in sepsis patients: A meta-analysis. Biomolecules & biomedicine. ;

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