A Study on the Prognosis of Patients with Sepsis or Septic Shock Based on Plasma Proenkephalin Levels: A Meta-Analysis

BACKGROUND: Sepsis can induce multiple organ dysfunction, and its complications, such as acute kidney injury, are associated with poor prognoses. Serum pro-enkephalin (pro-ENK), as a stable biomarker, holds potential value for risk stratification and prognostic assessment in sepsis. This review aimed to investigate its value through a meta-analysis. METHODS: Databases (PubMed, Embase, Cochrane Library, Web of Science) were searched from database establishment to June 16, 2025, and literature was screened according to the established PICOS principles. Cohort studies that examined the relationship between pro-ENK levels and poor prognosis were included. Data were extracted, and study quality was appraised via the NOS (Newcastle-Ottawa Scale) assessment tool. This meta-analysis was conducted using Stata 15.0. RESULTS: 9 studies were included, with sample sizes ranging from 40 to 956 participants per study. In sepsis or shock patients, pro-ENK levels were higher in the AKI group (SMD: 1.82, 95% CI: 1.26-2.39); pro-ENK levels were higher in the non-survivor group among patients with sepsis or shock (SMD: 0.85, 95% CI: 0.60-1.10). AKI occurrence was associated with penKid levels (OR: 2.50, 95% CI: 2.02-2.99). CONCLUSION: Current evidence identifies pro-ENK as an auxiliary biomarker for sepsis-related AKI and its prognosis and provides valuable insights for further clinical research.