Correlation analysis of the expression levels of serum endothelial cell adhesion molecule-1 and sirtuin 1 protein in acute respiratory distress syndrome.

Background: To investigate the relationships among the expression levels of serum silencing information regulator 2-related enzyme 1 (SIRT1), endothelial cell-specific molecule-1 (ESM-1), and fibroblast growth factor-21 (FGF21) and treatment results in patients with acute respiratory distress syndrome (ARDS) associated with sepsis. Methods: A total of 140 patients with sepsis-related ARDS were selected and divided into a good-outcome group (96 patients) and a poor-outcome group (44 patients) based on treatment outcome. The levels of serum SIRT1, ESM-1, and FGF21 were compared between the two groups; the correlations between serum SIRT1, ESM-1, and FGF21 and disease severity and treatment outcome were analysed; and the predictive value of serum SIRT1, ESM-1, and FGF21 for treatment outcomes was evaluated. Results: Compared with those in the group with favourable outcomes, the serum SIRT1 level was lower, while the ESM-1 and FGF21 levels were significantly higher in the poor outcome group than in the good outcome group (P<0.05). Serum SIRT1 levels decreased steadily in patients with mild, moderate, and severe illness, whereas ESM-1 and FGF21 levels increased consistently (P<0.05). ESM-1 and FGF21 showed a positive association with illness severity (P<0.05), whereas serum SIRT1 was negatively correlated (P<0.05) with disease severity according to Spearman correlation analysis. Partial correlation analysis indicated that serum SIRT1, ESM-1, and FGF21 levels were significantly related to treatment outcomes in patients with sepsis-related ARDS (P<0.05). The levels of serum SIRT1, ESM-1, and FGF21 and treatment outcomes were strongly linked (P<0.05) in patients with sepsis-related ARDS. The areas under the curve (AUCs) for predicting treatment course in patients with ARDS associated with sepsis were 0.742 for SIRT1, 0.838 for ESM-1, and 0.796 for FGF21. The sensitivities were 77.27% and 70.45%, and the specificities were 64.58%, 81.25%, and 87.50%, respectively. For patients with sepsis-related ARDS, the combined AUC of the three markers for treatment outcome was 0.939, with a sensitivity of 88.64% and a specificity of 83.33%, significantly surpassing the individual predictive values of the three markers alone (P<0.05). Conclusions: The levels of serum SIRT1, ESM-1, and FGF21 in patients with sepsis-related ARDS are strongly associated with both treatment efficacy and illness severity, can independently predict treatment outcomes, and have greater combined predictive value.