title: Discrimination of sepsis stage metabolic profiles with an LC/MS-MS-based metabolomics approach.
abstract: BACKGROUND
  To identify metabolic biomarkers that can be used to differentiate sepsis from systemic inflammatory response syndrome (SIRS), assess severity and predict outcomes.
  
  
  METHODS
  65 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  The body produces significant evidence of metabolic disorder during SIRS or sepsis. Seven metabolites may potentially be used to diagnose sepsis.
  
  
  BACKGROUND
  ClinicalTrial.gov identifier NCT01649440.
authors.affiliation: 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.
authors.forename: Longxiang
authors.initials: L
authors.lastname: Su
authors.affiliation: Shenzhen Proteome Engineering Laboratory , BGI Shenzhen , Shenzhen , China.
authors.forename: Yingyu
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Shenzhen Proteome Engineering Laboratory , BGI Shenzhen , Shenzhen , China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Decision-Consulting Office, Chinese PLA General Hospital , Beijing , China.
authors.forename: Lei
authors.initials: L
authors.lastname: Xia
authors.affiliation: Department of Respiratory Medicine , Chinese PLA General Hospital , Beijing , China.
authors.forename: Rentao
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine , Chinese PLA General Hospital , Beijing , China.
authors.forename: Kun
authors.initials: K
authors.lastname: Xiao
authors.affiliation: Department of Respiratory Medicine , Chinese PLA General Hospital , Beijing , China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine , Chinese PLA General Hospital , Beijing , China.
authors.forename: Peng
authors.initials: P
authors.lastname: Yan
authors.affiliation: Shenzhen Proteome Engineering Laboratory , BGI Shenzhen , Shenzhen , China.
authors.forename: Bo
authors.initials: B
authors.lastname: Wen
authors.affiliation: Shenzhen Proteome Engineering Laboratory , BGI Shenzhen , Shenzhen , China.
authors.forename: Lichao
authors.initials: L
authors.lastname: Cao
authors.affiliation: Shenzhen Proteome Engineering Laboratory , BGI Shenzhen , Shenzhen , China.
authors.forename: Nan
authors.initials: N
authors.lastname: Meng
authors.affiliation: Shenzhen Proteome Engineering Laboratory , BGI Shenzhen , Shenzhen , China.
authors.forename: Hemi
authors.initials: H
authors.lastname: Luan
authors.affiliation: Nanlou Respiratory Diseases Department , Chinese PLA General Hospital , Beijing , China.
authors.forename: Changting
authors.initials: C
authors.lastname: Liu
authors.affiliation: Clinical division of Internal Medicine , Chinese PLA General Hospital , Beijing , China.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Respiratory Medicine , Chinese PLA General Hospital , Beijing , China.
authors.forename: Lixin
authors.initials: L
authors.lastname: Xie
keywords: Respiratory Infection