A Potential Role for GLUT4 in Predicting Sepsis in Critically Ill Children

Abstract

Background: This study investigated serum Glucose transporter (GLUT) 4 levels and examined the relationship between serum GLUT4 levels and sepsis in critically ill children. Methods: This was a retrospective study of 77 critically ill children and 33 non-diabetic healthy children (controls) who were admitted between 07/2015 and 05/2016. Patient data, clinical information, and blood samples were collected on admission, alongside a large number of laboratory parameters that were routinely assessed. Critically ill patients were divided into sepsis and non-sepsis/systemic inflammatory response syndrome (SIRS). Serum GLUT4 was measured using western blotting and enzyme-linked immunosorbent assays. Insulin resistance indexes, clinical data, laboratory parameters, and inflammatory cytokines were assessed. Results: GLUT4 serum levels were higher in critically ill children than in healthy children (90.5 vs. 30.3 µg/L, P < 0.001), and in septic shock compared with sepsis (116.8 vs. 64.3 µg/L, P < 0.05), but not compared to non-sepsis/systemic inflammatory response syndrome (105.7 µg/L, P > 0.05). Compared to healthy children, hyperglycemic patients (n = 48) had elevated GLUT4 serum levels (30.3 vs. 103.7 g/L, P < 0.001). Serum GLUT4 levels were higher in patients who died (n = 16, P < 0.05) than in those who survived (n = 57). Serum GLUT4 levels were positively correlated with the neutrophil count, creatine kinase levels, and glucose levels (P < 0.05). GLUT4 levels for the diagnosis of sepsis had an area under the curve of 0.70 (P = 0.03) when using a 51-µg/L cut-off value, resulting in 74.6% sensitivity and 80% specificity. Conclusions: GLUT4 serum levels might be significantly increased in critically ill children compared with healthy children, particularly those in septic shock. Serum GLUT4 could predict disease severity.