The Relationship Between Islet Beta-Cell Dysfunction And Major Organ Dysfunction In Patients With Severe Traumatic Mods

Background: There is a lack of clinical evidence on the relationship between islet beta-cell dysfunction with the prognosis and the major organ dysfunction in the patients with severe traumatic MODS. Methods: 170 cases of surviving and dead traumatic MODS patients and 90 normal healthy individuals were selected as research subjects. The declined indexes of the HOMA-beta and Delta INS30/Delta GLU(30) were evaluated as indicators of beta-cell dysfunction, the elevated levels of blood ALT, CRE, and CK-MB were evaluated as liver, kidney and myocardium dysfunction indicators, and the elevated levels of blood sTREM-1, TNF-alpha, IL-6 and HMGB1 were analyzed as indicators of inflammation in all the subjects. Results: The indexes of HOMA-beta and Delta INS30/Delta GLU(30) in all the MODS patients were significantly lower than those of the normal control subjects, and the indexes of HOMA-beta and Delta INS30/Delta GLU(30) in the dead MODS patients were significantly lower than those of the surviving MODS patients, respectively (P<0.01). There was a significant negative correlation between either the HOMA-beta or Delta INS30/Delta GLU(30) with the ALT, CRE, and CK-MB, as well as the sTREM-1, TNF-alpha, IL-6, and HMGB1 levels in all the MODS patients, respectively (P<0.01). Conclusion: Islet beta-cell dysfunction occurs in patients with severe traumatic MODS and it predicts a poor outcome. Islet beta-cell dysfunction is positively related to liver, kidney, and myocardium dysfunction, and excessive inflammation may be an important cause of islet beta-cell dysfunction.