Abstract

GAYDOU, Luisa; BERTUZZI, Romina  and  MORETTI, Edgardo. Sepsis as a stressor: association with serum levels of cortisol, C reactive protein and interleukin 1b. Acta bioquím. clín. latinoam. [online]. 2009, vol.43, n.3, pp.299-305. ISSN 0325-2957.

Stress has a high prevalence in the world; one of its causes is sepsis. During this syndrome, cytokines are released, which activate the hypothalamic - pituitary - adrenal (HPA) axis. This raises cortisol levels and acute phase proteins. The goal of this work was to analize the effects of sepsis on the HPA axis, through cortisol measurements, and to associate it with interleukin 1 beta (IL1-b) and C reactive protein (CRP). Cortisol was measured by electrochemoluminiscence, CRP by immunoturbidimetric method and IL1-b by ELISA in sera of septic (S, n=40) and non septic (NS, n=21) patients. Cortisol was significantly higher than its cut-off (CO), established by ROC curves, in 63% of S patients, and only in 14% of NS (OR: 10,0; CI: 2.5 - 39.7; p<0.05). CRP was elevated in 55% of S, and in 43% of NS (p>0.05). In some S patients, very high levels of IL1-b were observed on the day of admission. The joint elevation of CRP and cortisol was of 40% in S and 5% in NS, while rises in all parameters were only seen in S (8%). It can be concluded that in the group of patients studied sepsis acted as an activator of the HPA axis, as evidenced by the elevated cortisol levels.

Keywords : Stress; Sepsis; Cortisol; Interleukin 1b; C reactive protein.

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