Correlation of serum H-FABP, sTREM-1, and HMGB1 levels with severity and prognosis of sepsis.

Objective: To investigate the correlation between serum levels of Heart-type fatty acid binding protein (H-FABP), Soluble Triggering Receptor Expressed on Myeloid Cells 1 (sTREM-1), and High mobility group box 1 protein (HMGB1) with disease severity, and their prognostic value in sepsis.

Methods: A retrospective analysis was conducted using the clinical data from 86 sepsis patients admitted to West China Hospital of Sichuan University between June 2021 and December 2023, and these cases constituted the observation group. In addition, clinical data from 80 healthy individuals who underwent medical examinations at our hospital during the same period served as the control group. Serum levels of H-FABP, sTREM-1, and HMGB1 were measured in both groups. Based on disease severity, the patients were categorized into mild (n=42), severe (n=28), and shock (n=16) groups. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score was used to assess the patients' condition. Follow-up evaluations showed that 60 patients survived and 26 died.

Results: Serum levels of H-FABP, sTREM-1, and HMGB1 were significantly higher in the observation group compared to the control group (all P<0.05). Among the sepsis patients, the severe and shock groups exhibited significantly elevated levels of H-FABP, sTREM-1, and HMGB1 compared to the mild group, with the shock group showing the highest levels (all P<0.05). The levels of H-FABP, sTREM-1, and HMGB1 were positively correlated with APACHE II scores (r=0.760, r=0.715, r=0.709, all P<0.001). Furthermore, the levels of these biomarkers were significantly higher in patients who died than in survivors (all P<0.05). The AUCs of H-FABP, sTREM-1, and HMGB1 for predicting prognosis were 0.786, 0.790, and 0.781, respectively. Their combined prediction yielded an AUC of 0.834. Log-rank test showed that the survival time of patients with different expression levels of sTREM-1 (<856.50 pg/ml, ≥856.50 pg/ml) and HMGB1 (<395.80 ng/ml, ≥395.80 ng/ml) were significantly different (P<0.05).

Conclusion: Serum levels of H-FABP, sTREM-1, and HMGB1 are elevated in sepsis patients and closely associated with the disease severity, making them valuable biomarkers for monitoring the severity of sepsis. Combined detection of serum H-FABP, sTREM-1, and HMGB1 shows promising prognostic value in sepsis, with lower levels of sTREM-1 and HMGB1 linked to improved survival.