BMC pediatrics · 2025
Complement levels and their diagnostic utility in neonatal sepsis.
СтатьяНазвание и аннотация: Перевод в очереди
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Diao Fuqiang, Zhong Feng, Tang Lingling, Gu Chunming, Guo Junfei, Wu Lihong, Wu Weixiang, Luo Mingyong
Аннотация
BACKGROUND: This study evaluated the diagnostic value of complement levels in neonatal sepsis and their roles in disease progression.
METHODS: This diagnostic accuracy study, conducted in Guangdong Province, China (January 2021-February 2022), involved 41 neonates with sepsis and 41 controls matched by sex and gestational age. Cases included neonates with culture-positive or clinically diagnosed sepsis, while controls consisted of neonates hospitalized for non-septic conditions, confirmed by negative blood cultures. Ten complement components (C1q, C3, C3c, C3b, C4, C5, C5a, H, B, mannose-binding lectin [MBL]) were quantified using residual specimens from routine clinical tests. Descriptive statistics, logistic regression, ROC curve analysis, and correlation assessments were introduced in this study.
RESULTS: The neonatal sepsis group had significantly higher levels of C3c (0.68 vs. 0.49 ng/mL, P = 0.007) and MBL (518.81 vs. 397.06 pg/mL, P < 0.001) compared to controls. In contrast, C5a levels were significantly lower in neonates with sepsis (51.18 vs. 57.25 ng/mL, P = 0.042). C5a demonstrated limited individual performance (AUC = 0.63, 95% CI: 0.51-0.75; sensitivity = 65.9%, specificity = 65.9% at 55.63 ng/mL), while MBL showed moderate accuracy (AUC = 0.75, 95% CI: 0.64-0.85; specificity = 90.2%, sensitivity = 53.7% at 512.86 pg/mL). Notably, their combined C5a + MBL indicator achieved exceptional discrimination (AUC = 0.92, 95% CI: 0.85-0.99) with 85.4% sensitivity and 97.6% specificity, yielding 97.2% positive predictive value (PPV) and 87.0% negative predictive value (NPV).Positive correlations were found between C4 levels and C-reactive protein (CRP), and C3 levels and neutrophil percentage (Neut%), while negative correlations were observed between C5 and MBL levels and total cholesterol (TCH).
CONCLUSIONS: This study highlights the diagnostic significance of combined C5a + MBL indicator in neonatal sepsis and underscores the association between complement levels and disease progression.
METHODS: This diagnostic accuracy study, conducted in Guangdong Province, China (January 2021-February 2022), involved 41 neonates with sepsis and 41 controls matched by sex and gestational age. Cases included neonates with culture-positive or clinically diagnosed sepsis, while controls consisted of neonates hospitalized for non-septic conditions, confirmed by negative blood cultures. Ten complement components (C1q, C3, C3c, C3b, C4, C5, C5a, H, B, mannose-binding lectin [MBL]) were quantified using residual specimens from routine clinical tests. Descriptive statistics, logistic regression, ROC curve analysis, and correlation assessments were introduced in this study.
RESULTS: The neonatal sepsis group had significantly higher levels of C3c (0.68 vs. 0.49 ng/mL, P = 0.007) and MBL (518.81 vs. 397.06 pg/mL, P < 0.001) compared to controls. In contrast, C5a levels were significantly lower in neonates with sepsis (51.18 vs. 57.25 ng/mL, P = 0.042). C5a demonstrated limited individual performance (AUC = 0.63, 95% CI: 0.51-0.75; sensitivity = 65.9%, specificity = 65.9% at 55.63 ng/mL), while MBL showed moderate accuracy (AUC = 0.75, 95% CI: 0.64-0.85; specificity = 90.2%, sensitivity = 53.7% at 512.86 pg/mL). Notably, their combined C5a + MBL indicator achieved exceptional discrimination (AUC = 0.92, 95% CI: 0.85-0.99) with 85.4% sensitivity and 97.6% specificity, yielding 97.2% positive predictive value (PPV) and 87.0% negative predictive value (NPV).Positive correlations were found between C4 levels and C-reactive protein (CRP), and C3 levels and neutrophil percentage (Neut%), while negative correlations were observed between C5 and MBL levels and total cholesterol (TCH).
CONCLUSIONS: This study highlights the diagnostic significance of combined C5a + MBL indicator in neonatal sepsis and underscores the association between complement levels and disease progression.