Journal of Circulating Biomarkers

Monocyte Distribution Width (MDW) as a useful and cost-effective biomarker for sepsis prediction

Dimitrios Theodoridis — 2025-08-14

Background: Sepsis is a life-threatening condition and a major cause of hospital mortality worldwide. This study
investigated the diagnostic utility of monocyte mean volume (MONO MEAN-V), monocyte distribution width
(MDW), monocyte mean conductivity (MONO MEAN-C), and monocyte standard deviation conductivity (MONO
Sd-C) for sepsis, compared to conventional markers.
Methods: A prospective cohort study was conducted in two centers, enrolling adult patients classified into three
groups: sepsis, septic shock, and febrile. Blood was drawn from septic patients on days 1, 3, and 5 of admission.
MDW and other inflammatory parameters were measured in all patients.
Results: Patients with sepsis or septic shock exhibited significantly elevated MONO MEAN-V, MDW, and MONO
MEAN-C and lower MONO Sd-C compared to febrile patients. Among the biomarkers evaluated, MDW emerged
as a reliable predictor of sepsis. A cut-off MDW value of 25.1 on day 1 demonstrated optimal diagnostic performance,
with an area under the ROC curve of 0.84 (95% CI: 0.77-0.91), sensitivity of 75%, and specificity of 91.2%.
Conclusions: MDW appears to be a cost-effective, rapid marker for sepsis detection, performing at least as effectively
as existing biomarkers. Our findings corroborate other published studies, highlighting MDW’s potential to
enhance early sepsis recognition.

A comparison of inflammatory markers’ potential to predict weight loss in advanced cancer: a prospective observational study

Ola Magne Vagnildhaug — 2025-07-28

Background: Systemic inflammation is crucial in cancer cachexia, but the optimal measurement method remains
unclear. This study compares markers of systemic inflammation (MoSI) in predicting weight loss in patients with
metastatic cancer.
Methods: This prospective, observational multi-center study involved patients undergoing radiotherapy for
bone metastases. Baseline assessments included demographics, clinical characteristics, previous weight loss,
and appetite loss. MoSI included: C-reactive protein (CRP), albumin, white blood cells, neutrophil-to-lymphocyte
ratio, monocyte-to-lymphocyte ratio, interleukin-6 (IL-6), modified Glasgow Prognostic Score (mGPS), and
Prognostic Nutritional Index. Body weight was recorded at baseline, 3, and 8 weeks post-radiotherapy. Multiple
linear regression assessed MoSI’s predictive ability for weight loss, adjusting for previous weight loss, appetite
loss, and primary tumour type. Goodness-of-fit was assessed using adjusted R2.
Results: Out of 574 recruited patients, 540 and 470 were analyzed at 3 and 8 weeks, respectively. The median age
(IQR) was 67 (15), 330 (61%) were male, and 397 (74%) had a Karnofsky performance status ≥70. In a base model
without MoSI, significant predictors of weight loss at 3 weeks were appetite loss and urological, lung, and gastrointestinal
cancer (adjusted R2 of 0.064), while at 8 weeks, urological and lung cancer were significant (adjusted R2
of 0.035). At 3 weeks, all MoSI significantly improved the base model, with adjusted R2 between 0.078 and 0.091.
At 8 weeks: CRP, mGPS, albumin and IL-6 improved the model; however only CRP and mGPS retained an adjusted
R2 of ~0.09.
Conclusions: All MoSI predicted weight loss, but CRP and mGPS were the most optimal.

Soluble interleukin-33 receptor (sST-2): a novel marker for assessing cardiovascular risk in rheumatoid arthritis

Inga Claus — 2025-07-28

Background: Rheumatoid arthritis (RA) is the most common inflammatory rheumatic disease, and it significantly
increases the risk of cardiovascular disease and death. The evaluation of cardiovascular risk (CVR) is crucial in
these patients, but it may be underestimated using the current criteria, as they do not include nontraditional
CVR factors. Soluble ST-2, which is the circulating form of the IL-33 receptor, has been identified as a biomarker
for cardiovascular and rheumatic diseases. In this study, we examined the role of sST-2 in assessing CVR in RA.
Methods: Monocentric, retrospective, observational trial. Inclusion of RA patients on variable DMARD therapy.
Analysis of RA disease using established scores (DAS 28, VAS, HFQ), clinical findings (number of swollen and painful
joints), and laboratory investigation. Documentation of numerous CVR variables. Quantification of soluble
sST-2 by ELISA.
Results: In total, 129 individuals were included. Soluble sST-2 did neither correlate nor was associated with any
variable of RA disease activity. In contrast, significant associations were identified between sST-2 and a number
of established CVR markers.
Conclusions: The data indicates a novel role for sST-2 in CVR prediction in RA.

Irisin and Insulin Interplay in Thyroid Disorders: A Pilot Study

Amisha Malhotra — 2025-06-09

Background: This research was performed to evaluate Irisin and Insulin concentrations in Thyroid patients.
Material and methods: This investigation was performed as a cross-sectional study within the Biochemistry
Department at KMC, Mangalore, and the Central Lab at KMCH-AT, Mangalore. Participants were classified into
two cohorts: those having regular thyroid function as well as those having thyroid disorder, including both hypothyroid and hyperthyroid patients, with 28 individuals (n = 28) in each category based on thyroid stimulating
hormone (TSH) levels obtained during thyroid dysfunction screenings. Socio-demographic variables like height,
weight, and body mass index were calculated, along with the assessment of hypertensive or hypotensive conditions. Insulin levels were quantified using an automated analyzer system. Statistical analyses were performed
utilizing Easy-R (EZR) version 1.55, developed by Jichi Medical University in Saitama, Japan. The normal distribution
of the parameters was evaluated through normality tests, with t-tests and Kruskal-Wallis tests applied as
appropriate.
Results: Irisin levels significantly declined in hypothyroid individuals while showing an insignificant rise in hyperthyroidism. Insulin levels significantly increased in hyperthyroid patients compared to normal and hypothyroid groups. A positive correlation between insulin and irisin was found in hypothyroidism, while a negative correlation was observed in hyperthyroidism.
Conclusion: Preliminary findings of this study indicate a potential interdependence between Irisin and thyroid
levels. Investigating the interaction between the thyroid profile and irisin can pave the way for considering irisin
as a biomarker for novel treatment strategies in thyroid disorders and metabolic conditions.