Serum levels of sirtuin 6 are associated with severe community acquired pneumonia in children: An observational study

Abstract

Objective: The objective of this study was to investigate the role of sirtuin 6 (SIRT6) in severe community acquired pneumonia (CAP) in child patients. Methods: This prospective observational research enrolled a total of 75 severe child CAP patients who went to our hospital during April 2016 to December 2020, and 75 mild/moderate CAP child patients were included as control. SIRT6 and inflammatory factors C-reactive protein (CRP), interleukin (IL)-6, and procalcitonin (PCT) were tested by the enzyme linked immunosorbent assay (ELISA). Demographic data including age, sex, as well as clinical symptoms, duration of ICU stay, duration of mechanical ventilation were collected. The routine blood test was conducted for all patients and WBC amount and neutrophil ratio were recorded. The pediatric critical illness score (PCIS) and 1-month mortality were collected. Results: Levels of SIRT6 were remarkably lower in severe CAP patients or deceased patients compared with mild/moderate or survival patients, respectively. Levels of CRP, PCT, and interleukin-6 (IL-6) were markedly higher in severe patients than mild/moderate patients. However, only levels of CRP were significantly higher in deceased CAP patients and serum levels of SIRT6 were negatively correlated with serum levels of CRP, PCT, and IL-6. The higher levels of CRP, PCT and IL-6, as well as higher mortality rate and lower levels of PCIS were found in patients with lower SIRT6 compared with parents with higher SIRT6. SIRT6 had the potential for diagnosis of severe CAP and patients with lower SIRT1 showed shorter 1-month survival. Further, logistic regression showed that only age and CRP were independent risk factors for 1-month mortality of CAP child parents. Conclusion: Down-regulated SIRT6 in severe CAP child patients predicted higher expression of inflammatory factors, severer clinical outcomes and poor prognosis.