Lactate dehydrogenase is associated with 28-day mortality in patients with sepsis: a retrospective observational study

Abstract

Background: Sepsis is a major health care problem, which affects millions of people around the world. Glucose metabolic reprogramming of immune cells plays a crucial role during advancement of sepsis. However, the association between glucose metabolic reprogramming and mortality in patients with sepsis is unclear. Lactate dehydrogenase (LDH) catalyzes the last step of glycolysis. Investigating the relationship between LDH and mortality is important to understand the effect of metabolic reprogramming on prognosis of patients with sepsis.

Methods: A total of 192 patients with sepsis were included in our study. Data on characteristics of patients, biochemical variables, and inflammatory mediator were collected. Association between the level of serum LDH and 28-day mortality was also analyzed. The correlations between serum LDH, interleukin-1β, creatinine, PaO₂/FiO₂, and lactate were also observed. The association between LDH and the risk of death was further analyzed. Moreover, receiver operating characteristic curve was depicted to compare the accuracy in prediction of LDH and other variables.

Results: There were statistic difference in 28-day mortality between elevated LDH group and normal LDH group (P = 0.021). Level of serum LDH was an independent risk factor for death of patients with sepsis (hazard ratio 1.005, 95% confidence interval 1.002-1.007, P = 0.001). There were significant correlations between LDH, interleukin-1β (r = 0.514, P = 0.000), creatinine (r = 0.368, P = 0.000), PaO₂/FiO₂ (r = -0.304, P = 0.000), and lactate (r = 0.560, P = 0.000). The receiver operating characteristic curves showed that the area under the LDH curve for prediction for mortality was 0.783.

Conclusions: Serum LDH is probably associated with 28-day mortality in patients with sepsis.

Keywords: Aerobic glycolysis; Lactic dehydrogenase; Sepsis; Septic shock; Warburg effect.