Objective To explore the value of long non-coding RNA insulin-like growth factor 2 antisense transcript (lncRNA IGF2-AS) and insulin-like growth factor 2 (IGF2) in evaluating the severity and prognosis of sepsis patients.

Methods A total of 120 patients with sepsis were grouped into sepsis group (70 cases) and septic shock group (50 cases) according to the severity of the disease. Patients with sepsis were divided into death group (n = 44) and survival group (n = 76) at a follow-up of 28 days after discharge. Meantime, 65 healthy volunteers were selected as the control group. The level of lncRNA IGF2-AS was detected by real-time fluorescence quantitative PCR, and the level of serum IGF2 was detected by enzyme linked immunosorbent assay. Pearson's method was used to analyze the correlation between serum levels of lncRNA IGF2-AS and IGF2, as well as to examine the relationship between serum levels of lncRNA IGF2-AS and IGF2 in sepsis patients and their SOFA scores, procalcitonin (PCT), interleukin-8 (IL-8), and interleukin-10 (IL-10). The predictive value of lncRNA IGF2-AS and IGF2 on the prognosis of patients with sepsis was analyzed by ROC curve. Logistic regression analysis was applied to analyze the factors affecting the prognosis of patients with sepsis.

Results Compared with control group, lncRNA IGF2-AS level in sepsis group and septic shock group was significantly increased (P ＜ 0.01 ~ P ＜ 0.05), and IGF2 level was decreased (P ＜ 0.05). Compared with sepsis group, the level of lncRNA IGF2-AS in septic shock group was obviously higher (P ＜ 0.05), and the level of IGF2 was obviously lower (P ＜ 0.05). Correlation analysis showed that there was a negative correlation between the levels of lncRNA IGF2-AS and IGF2 in the serum of patients with sepsis (r = –0.44, P ＜ 0.01). Serum lncRNA IGF2-AS levels in sepsis patients were positively correlated with SOFA score, PCT, IL-8 and IL-10 (r = 0.51, 0.49, 0.51, 0.55, P ＜ 0.01). IGF2 level were negatively correlated with SOFA score, PCT, IL-8 and IL-10 (r = –0.53, –0.46, –0.50, –0.54, P ＜ 0.01). Compared with the survival group, the SOFA score, APACHE Ⅱ score, levels of TNF-α, IL-6, IL-8, IL-10, and lncRNA IGF2-AS levels in the death group were significantly increased (P ＜ 0.01), while IGF2 levels were decreased (P ＜ 0.01). The AUC predicted by the combination of the two was higher than that predicted by lncRNA IGF2-AS and IGF2 alone (Z = 18.49, P ＜ 0.01; Z = 26.65, P ＜ 0.01). Multivariate logistic regression analysis showed that increased expression of lncRNA IGF2-AS was a risk factor for prognosis in patients with sepsis (P ＜ 0.05).

Conclusion High expression of lncRNA IGF2-As and low expression of IGF2 in serum of patients with sepsis are related to the severity of the disease and poor prognosis of patients with sepsis.