title: Glucagon levels, disease severity, and outcome in severe sepsis.
abstract: OBJECTIVE
  Few studies on plasma glucagon levels in patients with sepsis have been performed. We aimed to assess clinical value of glucagon levels in comparison with clinical parameters and severity scores in patients with severe sepsis or septic shock.
  
  
  METHODS
  A total of 112 patients who were admitted to intensive care unit with severe sepsis or septic shock were included. Plasma levels of glucagon on days 0, 1, 3, and 7 were serially measured in 112 patients with severe sepsis or septic shock.
  
  
  RESULTS
  Compared with survivors, patients who died within 28 days had significantly higher glucagon levels on every day of examination. Glucagon levels were positively correlated with and Acute Physiology and Chronic Health Evaluation II score (day 0, r = 0.288, P < 0.01) and Sequential Organ Failure Assessment (day 0, r = 0.482, P< 0.01; day 1, r = 0.588, P < 0.01; day 3, r = 0.480, P < 0.01; day 7, r = 0.454, P < 0.01). Receiver operating characteristic analysis showed that the area under the curve of glucagon levels to predict 28-day survival was 0.65 (95% confidence interval [CI], 0.55-0.75; P = 0.005), similar to the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. Multivariate analysis revealed that glucagon levels of greater than 70 pg/mL (hazard ratio, 1.85; 95% CI, 1.03-3.29) and chronic liver disease (hazard ratio, 1.97; 95% CI, 1.02-3.79) were associated with mortality.
  
  
  CONCLUSIONS
  Glucagon levels might reflect disease severity and clinical outcomes in patients with severe sepsis or septic shock.
authors.affiliation: *Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Anam Hospital; and †Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Won Jai
authors.initials: WJ
authors.lastname: Jung
authors.forename: Byung Hoon
authors.initials: BH
authors.lastname: Park
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Chung
authors.forename: Song Yee
authors.initials: SY
authors.lastname: Kim
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kim
authors.forename: Ji Ye
authors.initials: JY
authors.lastname: Jung
authors.forename: Young Ae
authors.initials: YA
authors.lastname: Kang
authors.forename: Young Sam
authors.initials: YS
authors.lastname: Kim
authors.forename: Se Kyu
authors.initials: SK
authors.lastname: Kim
authors.forename: Joon
authors.initials: J
authors.lastname: Chang
authors.forename: Moo Suk
authors.initials: MS
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005934:Glucagon / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood*; D012772:Shock, Septic / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005934:Glucagon