Association of serum oncostatin M with disease severity and mortality in community-acquired pneumonia with diabetes mellitus

Table 1 Demographic and clinical characteristics of patients with community-acquired pneumonia in this study, n (%)/median (interquartile range)

Characteristics	CAP (n = 323)	DM-CAP (n = 87)	P value
Sex, male	186 (57.59)	57 (65.52)	0.181
Age, years	62 (41-74)	67 (61-78)	< 0.001
Underlying disease(s)
Chronic heart diseases	64 (19.81)	43 (49.43)	< 0.001
Hypertension	101 (31.27)	61 (70.11)	< 0.001
Chronic renal diseases	4 (1.24)	5 (5.75)	0.020
Cerebrovascular diseases	40 (12.38)	22 (25.29)	0.003
Chronic pulmonary diseases	22 (6.81)	9 (10.34)	0.899
Physical examination
T max, °C	36.80 (36.50-37.60)	36.90 (36.50-37.50)	0.701
Respiratory frequency ≥ 30 breaths/minute	8 (2.48)	5 (5.75)	0.002
Heart rates ≥ 100 beats/minute	61 (18.89)	24 (27.59)	0.002
Confusion	38 (11.76)	23 (26.44)	0.001
SBP < 90 mmHg or DBP ≤ 60 mmHg	17 (5.26)	7 (8.05)	0.326
Laboratory results
WBC (× 109/L)	7.75 (6.14-10.28)	8.54 (6.51-12.62)	0.010
NEU (× 109/L)	5.12 (3.53-7.54)	6.40 (4.30-10.86)	0.001
LYM (× 109/L)	1.58 (1.01-2.17)	1.34 (0.78-1.84)	0.013
CRP (mg/L)	19.70 (3.51-67.18)	47.11 (12.39-117.00)	0.001
PCT (μg/L)	0.06 (0.03-0.20)	0.16 (0.07-0.80)	< 0.001
Glu (mmol/L)	5.02 (4.55-5.97)	8.20 (6.11-12.17)	< 0.001
ALB (g/L)	37.37 (33.68-39.70)	36.07 (31.32-40.07)	0.094
Cr (μmol/L)	70.60 (58.14-83.49)	75.47 (63.58-100.20)	0.004
BUN (mmol/L)	4.80 (3.84-6.46)	6.04 (4.90-9.30)	< 0.001
Oncostatin M (pg/mL)	21.25 (9.76-44.59)	32.94 (14.54-72.34)	0.004
Interleukin-6 (pg/mL)	4.00 (2.15-8.30)	6.32 (3.38-15.21)	< 0.001
Interleukin-8 (pg/mL)	15.25 (11.19-22.02)	17.51 (12.76-31.09)	0.023
Chest CT
Multipolar infiltrates	168 (52.01)	54 (62.07)	0.095
Pleural effusion	53 (16.41)	19 (21.84)	0.237
Treatment
Intravenous hormone therapy	42 (13.00)	11 (12.64)	0.929
Vasoactive drug therapy	15 (4.64)	14 (16.09)	< 0.001
CURB-65 score	0 (0-1)	1 (0-2)	< 0.001
PSI score	61 (40-90)	85 (65-119)	< 0.001
In-hospital mortality	16 (4.95)	4 (4.60)	1.000
1-year mortality	34 (10.53)	17 (19.54)	0.024

Variables are expressed as n (%); mean ± SD for continuous variables conforming to a normal distribution; and median (interquartile range) for continuous nonparametric data. CAP: Community-acquired pneumonia; DM: Diabetes mellitus; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; WBC: White blood cell; NEU: Neutrophil; LYM: Lymphocyte; CRP: C-reactive protein; PCT: Procalcitonin; Cr: Creatinine; BUN: Blood urea nitrogen; Glu: Glucose; ALB: Albumin; CT: Computed tomography; CURB-65: Confusion, uremia, respiratory rate, blood pressure, and age ≥ 65 years; PSI: Pneumonia severity index.

Table 2 Comparisons of clinical characteristics and outcomes among diabetes mellitus-community-acquired pneumonia patients, mean ± SD/n (%)/median (interquartile range)

Characteristics	NSCAP (n = 61)	SCAP (n = 26)	P value
Sex, male	38 (62.30)	19 (73.10)	0.333
Age ≥ 65 years	33 (54.10)	22 (84.62)	0.007
Underlying disease(s)
Chronic heart diseases	26 (42.62)	17 (65.38)	0.052
Hypertension	43 (70.49)	19 (73.08)	0.807
Chronic renal diseases	4 (6.56)	1 (3.85)	1.000
Cerebrovascular diseases	9 (14.75)	13 (50.00)	0.001
Chronic pulmonary diseases	7 (11.48)	2 (7.69)	0.899
Laboratory results
WBC (× 109/L)	7.47 (6.11-10.70)	12.46 (9.51-14.88)	< 0.001
NEU (× 109/L)	4.86 (3.69-7.87)	10.69 (7.50-12.93)	< 0.001
LYM (× 109/L)	1.41 (0.96-2.01)	0.92 (0.52-1.64)	0.058
NLR	3.48 (1.95-8.36)	10.77 (5.26-40.28)	< 0.001
CRP (mg/L)	39.18 (10.60-117.67)	51.14 (16.40-105.65)	0.330
PCT (μg/L)	0.09 (0.05-0.25)	0.38 (0.17-1.59)	0.003
ALB (g/L)	37.39 (32.14-40.23)	32.81 ± 5.23	0.007
Cr (μmol/L)	72.66 (63.27-86.53)	100.80 (66.92-153.10)	0.009
BUN (mmol/L)	5.62 (4.70-7.07)	9.70 (8.13-19.19)	< 0.001
Oncostatin M (pg/mL)	26.89 (11.03-58.93)	56.29 (35.59-139.19)	0.001
Interleukin-6 (pg/mL)	4.74 (2.77-13.84)	11.00 (4.71-17.65)	0.020
Interleukin-8 (pg/mL)	14.91 (12.24-23.02)	26.85 (20.19-49.61)	0.001
CURB-65 score	1 (0-1)	3 (2-3)	< 0.001
PSI score	71.00 (59.50-87.50)	137.50 (121.25-156.75)	< 0.001
In-hospital mortality	0 (0)	4 (15.38)	0.007
1-year mortality	2 (3.28)	15 (57.69)	< 0.001

Variables are expressed as n (%); mean ± SD for continuous variables conforming to a normal distribution; and median (interquartile range) for continuous nonparametric data. SCAP: Severe community-acquired pneumonia; NSCAP: Non-severe community-acquired pneumonia; WBC: White blood cell; NEU: Neutrophil; LYM: Lymphocyte; CRP: C-reactive protein; NLR: Neutrophil-to-lymphocyte ratio; PCT: Procalcitonin; ALB: Albumin; Cr: Creatinine; BUN: Blood urea nitrogen; CURB-65: Confusion, uremia, respiratory rate, blood pressure, and age ≥ 65 years; PSI: Pneumonia severity index.

Table 3 Correlation analysis between serum oncostatin M and various inflammatory indicators

Variable	Analysis	CURB‐65	PSI score	WBC	NEU	NLR	PCT	IL-6	IL-8
OSM	r/P value	0.327/0.002	0.353/0.0008	0.537/< 0.0001	0.606/< 0.0001	0.588/< 0.0001	0.621/< 0.0001	0.567/< 0.0001	0.622/< 0.0001

OSM: Oncostatin M; CURB-65: Confusion, uremia, respiratory rate, blood pressure, and age ≥ 65 years; PSI: Pneumonia severity index; WBC: White blood cell; NLR: Neutrophil-to-lymphocyte ratio; PCT: Procalcitonin; IL-6: Interleukin-6; IL-8: Interleukin-8; NEU: Neutrophil.

Table 4 Area under the curve and thresholds for predicting 1-year mortality in community-acquired pneumonia patients with diabetes mellitus

Variable	AUC	95%CI		Sensitivity (%)	Specificity (%)	Threshold	P value
		Lower limit	Upper limit
IL-6 (pg/mL)	0.596	0.458	0.733	64.7	67.1	> 9.10	0.222
IL-8 (pg/mL)	0.721	0.574	0.868	76.5	75.7	> 23.60	0.005
OSM (pg/mL)	0.738	0.622	0.854	82.4	62.9	> 35.62	0.002
PCT (μg/L)	0.751	0.606	0.897	82.4	75.7	> 0.28	0.001
CRP (mg/L)	0.575	0.420	0.730	17.6	98.6	> 233.92	0.341
WBC (× 109/L)	0.724	0.592	0.856	82.4	62.9	> 8.92	0.004
NEU (× 109/L)	0.748	0.628	0.868	82.4	62.9	> 7.12	0.002
NLR	0.718	0.583	0.845	82.4	55.7	> 5.05	0.005
CURB-65	0.879	0.803	0.955	94.1	74.3	> 1.5	< 0.0001
PSI score	0.882	0.788	0.975	88.2	81.4	> 109.50	< 0.0001
CURB-65 + OSM	0.903	0.837	0.970	94.1	82.9	> 0.21	< 0.0001
PSI score + OSM	0.879	0.784	0.974	88.2	77.1	> 0.17	< 0.0001

AUC: Area under the curve; CI: Confidence interval; IL-6: Interleukin-6; IL-8: Interleukin-8; OSM: Oncostatin M; PCT: Procalcitonin; CRP: C-reactive protein; WBC: White blood cell; NLR: Neutrophil-to-lymphocyte ratio; NEU: Neutrophil; CURB-65: Confusion, uremia, respiratory rate, blood pressure, and age ≥ 65 years; PSI: Pneumonia severity index.

Table 5 Analysis of risk factors affecting the 1-year mortality in diabetes mellitus-community-acquired pneumonia patients

Variable	Univariate analysis		Multivariate analysis
	OR (95%CI)	P value	OR (95%CI)	P value
Age, years	1.094 (1.035-1.156)	0.001	1.070 (1.004-1.141)	0.038
Sex, male	0.699 (0.236-2.073)	0.519
Chronic heart diseases	2.177 (0.724-6.542)	0.166
hypertension	0.960 (0.299-3.078)	0.945
Chronic renal diseases	1.031 (0.108-9.866)	0.979
Cerebrovascular diseases	3.556 (1.162-10.876)	0.026
Chronic pulmonary diseases	1.200 (0.226-6.370)	0.830
ALB (g/L)	0.863 (0.774-0.963)	0.009
Cr (μmol/L)	1.011 (1.003-1.020)	0.010
BUN (mmol/L)	1.218 (1.092-1.359)	< 0.0001	1.183 (1.049-1.333)	0.006
LYM (× 109/L)	0.618 (0.301-1.270)	0.190
NLR	1.043 (1.001-1.077)	0.008
PCT (μg/L)	1.198 (0.951-1.509)	0.125
CRP (mg/L)	1.005 (0.998-1.012)	0.177
IL-6 (pg/mL)	1.001 (0.977-1.026)	0.947
IL-8 (pg/mL)	1.034 (1.007-1.061)	0.013
OSM (pg/mL)	1.006 (1.000-1.012)	0.042	1.008 (1.001-1.014)	0.030

OR: Odds ratio; CI: Confidence interval; ALB: Albumin; Cr: Creatinine; BUN: Blood urea nitrogen; LYM: Lymphocyte; NLR: Neutrophil-to-lymphocyte ratio; PCT: Procalcitonin; IL-6: Interleukin-6; IL-8: Interleukin-8; OSM: Oncostatin M; CRP: C-reactive protein.