(1580) SCD1 Enzyme Activity Is Associated With Elevated Creatinine Levels in Pediatric Sepsis

Introduction: Fatty acid desaturation with the enzyme Stearoyl-CoA desaturase (SCD1) regulates the proportions of monounsaturated to saturated fatty acids. Higher SCD1 activity has been consistently associated with human obesity, insulin resistance, and increasing inflammation, but scarcely studied in sepsis. Recently sepsis phenotypes were described in critically ill pediatric patients, with phenotype D being characterized by multiorgan failure and high mortality. We hypothesize that higher SCD1 activity will be associated with sepsis phenotype D and with end-organ injury.

Methods: We estimated SCD1 activity in pediatric sepsis phenotypes and organ injury by means of metabolite/precursor ratio (16:1/16:0) using untargeted metabolomics. We included 108 pediatric critically ill patients with sepsis (27 each of phenotypes A-D). Organ injury was evaluated by days meeting criteria of injury during follow up: hepatic (ALT>100U and Total bilirubin >1mg/dL), hematologic (platelet count < 100,000 and INR>1.5), and renal (creatinine >1mg/dL and oliguria). Acute kidney injury was further evaluated by linear association with serum creatinine.

Results: SCD1 activity was not associated with pediatric sepsis phenotypes, with organ injury days, lactate, or with hospital mortality. SCD1 activity was strongly associated with increasing serum creatinine in multivariate regression (OR 1.63, p < 0.01), confirmed in logistic regression with categorized creatinine level (OR 3.11, p < 0.01). Results were similar in sensitivity analyses with SCD1 estimation utilizing the 18-carbon series fatty acids (18:1/18:0).

Conclusions: SCD1 activity was associated with serum creatinine in a cohort of pediatric critically ill patients with sepsis. Future studies investigating determinants of SCD1 activity in this patient population are warranted.