Lysophosphatidic acid: a promising biomarker for diagnosing sepsis and predicting in-hospital mortality

Background: Lysophosphatidic acid (LPA) has anti-inflammatory and protective effects in sepsis, yet clinical evidence on its correlation with sepsis progression and outcomes is limited. This study aimed to evaluate the association of plasma LPA levels with sepsis development, severity, and mortality. Methods: A total of 42 sepsis patients and 29 controls with common infections were included. Among the sepsis patients, 15 succumbed during hospitalization. Plasma LPA levels were measured, and clinical data were retrospectively analyzed. Results: Plasma LPA was significantly lower in sepsis patients compared to controls, and further reduced in non-survivors. Notably, correlation analyses suggested that LPA levels were negatively correlated with neutrophil count, procalcitonin, interleukin-6, and Sequential Organ Failure Assessment (SOFA) score. Multivariate regression analysis identified LPA as an independent risk factor for sepsis onset and in-hospital mortality. Receiver operating characteristic (ROC) curve analysis revealed that LPA had a high diagnostic accuracy for sepsis (area under the ROC curve [AUC] = 0.92, 95% CI = 0.86-0.99, P < 0.001) and was a strong predictor of in-hospital mortality (AUC = 0.86, 95% CI = 0.76-0.97, P < 0.001). Conclusion: Reduced plasma LPA levels in sepsis patients are inversely correlated with infection/inflammation markers and SOFA scores. Together, these results suggest that LPA may serve as a potential diagnostic and prognostic biomarker for sepsis, supporting its potential as a complementary tool to enhance early risk stratification and guide bedside clinical decision-making.