U-Shape Relationship between Plasma Leucine Level and Mortality in the Intensive Care Unit

Patients in the intensive care unit (ICU) are at high risk of mortality which is not well predicted. Previous studies noted that leucine has prognostic value in a variety of diseases. This study investigated whether leucine concentration was a useful biomarker of metabolic and nutritional status and...

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Bibliographic Details
Published in:Disease markers 2022, Vol.2022, p.7389258-9
Main Authors: Wang, Mei-Ying, Wang, Chao-Hung, Chen, Wei-Siang, Chu, Chien-Ming, Wu, Huang-Ping, Liu, Min-Hui, Lin, Yi-Tsen, Kao, Kuo-Chin, Liang, Chung-Yu, Chen, Wen-Hsin, Wang, Huei-Jen, Lee, Shu-Chiu
Format: Article
Language:English
Subjects:
Age Factors
Aged
Alanine
Alanine transaminase
Albumin
Albumins
Amino acids
APACHE
Biomarkers
Biomarkers - blood
Blood
C-reactive protein
Cardiovascular disease
Chronic obstructive pulmonary disease
Coronary vessels
Critical Illness - mortality
Female
Hemoglobin
Hospital Mortality
Hospitals
Humans
Illnesses
Intensive care
Intensive Care Units - statistics & numerical data
Kidney diseases
Laboratories
Length of Stay - statistics & numerical data
Leucine
Leucine - blood
Male
Malnutrition
Metabolism
Mortality
Nutritional status
Organ Dysfunction Scores
Patients
Plasma
Prognosis
Proteins
Software
Survival
Transferrin
Vein & artery diseases
Weaning
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Summary:Patients in the intensive care unit (ICU) are at high risk of mortality which is not well predicted. Previous studies noted that leucine has prognostic value in a variety of diseases. This study investigated whether leucine concentration was a useful biomarker of metabolic and nutritional status and 6-month mortality in ICU. We recruited 454 subjects admitted to ICU (348 and 106 in the initiation and validation cohorts, respectively) with an acute physiology and chronic health evaluation (APACHE II) score≥15. We measured plasma leucine concentrations, traditional biomarkers, and calculated APACHE II and sequential organ failure assessment (SOFA) scores. Leucine levels were weakly correlated with albumin, prealbumin, and transferrin levels (r=0.30, 0.12, and 0.15, p=0.001, 0.029, and 0.007, respectively). During follow-up, 116 (33.3%) patients died. Compared to patients with leucine levels between 109 and 174 μM, patients with leucine>174 μM or 174 μM had higher alanine aminotransferase levels, but no significant differences in other variables; patients with leucine levels174 μM was an independent predictor of mortality, especially early mortality. However, among patients who stayed in ICU longer than two weeks, leucine
ISSN:0278-0240
1875-8630
DOI:10.1155/2022/7389258