Relationship between serum S1P and HIF-1α levels and intestinal barrier status and clinical prognosis in patients with sepsis
Objective To investigate the relationship between serum levels of sphingosine-1-phosphate(S1P)and hypoxia inducible factor-1α(HIF-1α)with intestinal barrier condition and clinical prognosis in patients with sepsis.Methods A total of 125 confirmed sepsis patients treated in our hospital from March 2021 to March 2023 were collected as the case group.They were separated into severe group(37 cases),moderate group(47 cases),and mild group(41 cases)based on their condition.They were separated into death group(41 cases)and survival group(84 cases)based on their prognosis.125 healthy individuals who underwent physical examination were regarded as the control group.Serum S1P and HIF-1α levels were compared.Logistic regression was applied to analyze the influencing factors of death.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum S1P and HIF-1α levels for death.Results The serum S1P level in the case group was obviously lower than that in the control group,and the HIF-1α level was obviously higher than that in the control group,all the differences were statistically significant(t=10.479,13.720;all P<0.05).As the disease progressed,serum S1P decreased sequentially,while levels of HIF-1α,diamine oxidase(DAO),intestinal fatty-acid binding protein(IFABP),and D-lactic acid(D-LAC)increased sequentially,all the differences were statistically significant(F=29.935,46.556,31.998,30.241,42.705;all P<0.05).The serum S1P level was negatively correlated with DAO,IFABP,and D-LAC(r=-0.589,-0.622,-0.599;all P<0.05),while the serum HIF-1α level was positively correlated with DAO,IFABP,and D-LAC(r=0.608,0.612,0.682;all P<0.05).The levels of HIF-1α,IL-6,and high mobility group box-1 protein(HMGB1)in the death group were obviously higher than those in the survival group;all the differences were statistically significant(t=6.016,12.273,4.040;all P<0.05),and the levels of S1P were obviously lower than those in the survival group(t=6.922,P<0.05).S1P was an independent protective factor for death(P<0.05),while HIF-1α,IL-6,and HMGB1 were independent risk factors for death(P<0.05).The area under the curve(AUC)of serum S1P and HIF-1α levels in predicting death were 0.839 and 0.824,respectively,the AUC predicted by the combination of the two was 0.930,the combined prediction of the two was better than SIP,HIF-1α individual prediction(Z=2.415,3.334,P=0.016,0.001).Conclusions Serum S1P level was down-regulated and HIF-1α level was up-regulated in sepsis patients,and their expression levels were closely related to intestinal barrier conditions.The combination of the two had higher value in predicting prognosis.
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