sST2、IL-33与慢性肾衰竭患者心力衰竭的相关性研究
|
摘要
目的探讨可溶性ST2(soluble ST2,sST2)、白介素-33(interleukin-33,IL-33)与慢性肾衰竭患者心力衰竭的相关性。方法选取2017年10月1日至2018年8月31日本院收治的慢性肾脏病(chronic kidney disease,CKD)患者116例为研究对象,根据国际改善全球肾脏病预后组织指南将其分为CKD 1～5期,同时选取2018年1月1日至2018年8月31日于本院健康体检的健康成人28例纳入对照组。比较不同CKD分期患者和对照组研究对象s ST2、IL-33、N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)的水平。对其中70例CKD 5期患者进行心功能分级,观察不同心功能分级患者sST2、IL-33、NT-proBNP表达水平的差异,并使用ROC曲线分析s ST2、IL-33、NT-proBNP诊断CKD 5期患者心功能Ⅳ级的价值。结果 CKD 1～5期患者sST2、IL-33、NT-proBNP水平均显著高于对照组(P_均<0.05)。CKD 5期患者NT-proBNP水平均显著高于CKD 1～4期患者(P_均<0.05)。随着心功能分级的增加,sST2、IL-33及NT-proBNP水平均逐渐升高,且不同心功能分级CKD 5期患者sST2、IL-33水平比较差异均具有显著性(P_均<0.05)。s ST2、IL-33及NT-proBNP对CKD 5期患者心功能Ⅳ级均具有一定的诊断价值,但sST2和IL-33的诊断价值均显著高于NT-proBNP。结论 sST2、IL-33及NT-proBNP在慢性肾衰竭患者中的表达水平均受心功能影响,但NT-proBNP受肾功能影响较大,而sST2、IL-33受肾功能影响较小,因此使用sST2、IL-33评价慢性肾衰竭患者的心功能可能更有价值。
Objective To investigate the correlation between soluble ST2(sST2), interleukin-33(IL-33) and heart failure in patients with chronic renal failure. Method From October 1, 2017 to August 31, 2018, 116 patients with chronic kidney disease(CKD) treated in our hospital were selected as subjects, they were divided into CKD stage 1 ～ 5 according to kidney disease:improving global outcomes(KDIGO), at the same time, 28 healthy adults who underwent physical examination in our hospital were selected and included in control group from January 1, 2018 to August 31, 2018. The levels of sST2, IL-33 and N-terminal proB-type natriuretic peptide(NT-proBNP) in patients with different CKD stage and control group were compared. Cardiac function classi?cation was performed in 70 patients with CKD stage 5, and the levels of sST2, IL-33 and NT-proBNP in patients with different cardiac function grades were observed. ROC curve was used to analyze the value of sST2, IL-33 and NT-proBNP in the diagnosis of grade Ⅳ cardiac function in patients with CKD stage 5. Result The levels of sST2, IL-33 and NT-proBNP in patients with CKD stage 1 ～ 5 were signi?cantly higher than those in control group(P_(all)< 0.05). The levels of NT-proBNP in patients with CKD stage 5 were signi?cantly higher than those in patients with CKD stage 1 ～ 4(P_(all)< 0.05). With the increase of cardiac function classification, the levels of sST2, IL-33 and NT-proBNP increased gradually, and there were significant differences in the levels of sST2 and IL-33 among CKD 5 patients with different cardiac function grades(P_(all)< 0.05). sST2, IL-33 and NT-proBNP had certain diagnostic value for grade Ⅳ cardiac function in patients with CKD stage 5, but the diagnostic value of sST2 and IL-33 were signi?cantly higher than NT-proBNP. Conclusion The expression of sST2, IL-33 and NT-proBNP in patients with chronic renal failure is affected by cardiac function, but NT-proBNP is greatly affected by renal function, while sST2 and IL-33 are less affected by renal function. Therefore, sST2 and IL-33 may be more valuable in evaluating cardiac function in patients with chronic renal failure.
Objective To investigate the correlation between soluble ST2(sST2), interleukin-33(IL-33) and heart failure in patients with chronic renal failure. Method From October 1, 2017 to August 31, 2018, 116 patients with chronic kidney disease(CKD) treated in our hospital were selected as subjects, they were divided into CKD stage 1 ～ 5 according to kidney disease:improving global outcomes(KDIGO), at the same time, 28 healthy adults who underwent physical examination in our hospital were selected and included in control group from January 1, 2018 to August 31, 2018. The levels of sST2, IL-33 and N-terminal proB-type natriuretic peptide(NT-proBNP) in patients with different CKD stage and control group were compared. Cardiac function classi?cation was performed in 70 patients with CKD stage 5, and the levels of sST2, IL-33 and NT-proBNP in patients with different cardiac function grades were observed. ROC curve was used to analyze the value of sST2, IL-33 and NT-proBNP in the diagnosis of grade Ⅳ cardiac function in patients with CKD stage 5. Result The levels of sST2, IL-33 and NT-proBNP in patients with CKD stage 1 ～ 5 were signi?cantly higher than those in control group(P_(all)< 0.05). The levels of NT-proBNP in patients with CKD stage 5 were signi?cantly higher than those in patients with CKD stage 1 ～ 4(P_(all)< 0.05). With the increase of cardiac function classification, the levels of sST2, IL-33 and NT-proBNP increased gradually, and there were significant differences in the levels of sST2 and IL-33 among CKD 5 patients with different cardiac function grades(P_(all)< 0.05). sST2, IL-33 and NT-proBNP had certain diagnostic value for grade Ⅳ cardiac function in patients with CKD stage 5, but the diagnostic value of sST2 and IL-33 were signi?cantly higher than NT-proBNP. Conclusion The expression of sST2, IL-33 and NT-proBNP in patients with chronic renal failure is affected by cardiac function, but NT-proBNP is greatly affected by renal function, while sST2 and IL-33 are less affected by renal function. Therefore, sST2 and IL-33 may be more valuable in evaluating cardiac function in patients with chronic renal failure.
引文
[1]Szummer K,Evans M,Carrero JJ,et al.Comparison of the Chronic Kidney Disease Epidemiology Collaboration,the Modification of Diet in Renal Disease study and the CockcroftGault equation in patients with heart failure[J].Open Heart,2017,4(2):e000568.
[2]Valente MA,Hillege HL,Navis G,et al.The Chronic Kidney Disease Epidemiology Collaboration equation outperforms the Modification of Diet in Renal Disease equation for estimating glomerular filtration rate in chronic systolic heart failure[J].Eur J Heart Fail,2014,16(1):86-94.
[3]Hwang H,Chae JB,Kim JY,et al.Changes in Optical Coherence Tomography Findings in Patients with Chronic Renal Failure Undergoing Dialysis for the First Time[J].Retina,2018.[Epub ahead of print]
[4]Keskin G,Babacan Gumus A,Tasdemir Yigitoglu G.Sexual dysfunctions and related variables with sexual function in patients who undergo dialysis for chronic renal failure[J].J Clin Nurs,2019,28(1-2):257-269.
[5]Li JP,Lu L,Wang LJ,et al.Increased serum levels of S100Bare related to the severity of cardiac dysfunction,renal insufficiency and major cardiac events in patients with chronic heart failure[J].Clin Biochem,2011,44(12):984-988.
[6]Nam SJ,Han SH,Kim HW,et al.The cardiac biomarker sodium-calcium exchanger(NCX-1)can differentiate between heart failure and renal failure:a comparative study of NCX-1 expression in dogs with chronic mitral valvular insufficiency and azotemia[J].J Vet Intern Med,2010,24(6):1383-1387.
[7]Park CS,Park JJ,Oh IY,et al.Relation of Renal Function with Left Ventricular Systolic Function and NT-proBNP Level and Its Prognostic Implication in Heart Failure with Preserved versus Reduced Ejection Fraction:an analysis from the Korean Heart Failure(KorHF)Registry[J].Korean Circ J,2017,47(5):727-741.
[8]Zhang J,Wong KY,Clark AL,et al.Exploring the relation between changes in NT-proBNP and renal function in pati ents with suspected heart failure using structural equation modelling[J].Int J Cardiol,2017,233:67-72.
[9]Franekova J,Hoskova L,Secnik P Jr,et al.The role of timely measurement of galectin-3,NT-proBNP,cystatin C and hsTnTin predicting prognosis and heart function after heart transplantation[J].Clin Chem Lab Med,2016,54(2):339-344.
[10]Zhou FJ,Zhou CY,Tian YJ,et al.Diagnostic value of analysis of H-FABP,NT-proBNP,and cTnI in heart function in children with congenital heart disease and pneumonia[J].Eur Rev Med Pharmacol Sci,2014,18(10):1513-1516.
[11]Perez-Downes J,Palacio C,Ibrahim S,et al.Prognostic utility of NT-proBNP greater than 70,000 pg/mL in patients with end stage renal disease[J].J Geriatr Cardiol,2018,15(7):476-478.
[12]Idzerda NMA,Persson F,Pena MJ,et al.N-terminal pro-brain natriuretic peptide(NT-proBNP)predicts the cardio-renal response to aliskiren in patients with type 2 diabetes at high renal and cardiovascular risk[J].Diabetes Obes Metab,2018,20(12):2899-2904.
[13]Gao P,Zhu Q,Bian S,et al.Prognostic value of plasma NT-proBNP levels in very old patients with moderate renal insufficiency in China[J].Z Gerontol Geriatr,2018,51(8):887-894.
[14]Saulnier PJ,Gand E,Velho G,et al.Association of Circulating Biomarkers(Adrenomedullin,TNFR1,and NT-proBNP)With Renal Function Decline in Patients With Type 2 Diabetes:A French Prospective Cohort[J].Diabetes Care,2017,40(3):367-374.
[15]Courand PY,Harbaoui B,Becle C,et al.Plasma NT-proBNPmirrors the deleterious cardiovascular and renal continuum in hypertension[J].Eur J Prev Cardiol,2017,24(5):452-459.
[16]Packer M,Claggett B,Lefkowitz MP,et al.Effect of neprilysin inhibition on renal function in patients with type 2 diabetes and chronic heart failure who are receiving target doses of inhibitors of the renin-angiotensin system:a secondary analysis of the PARADIGM-HF trial[J].Lancet Diabetes Endocrinol,2018,6(7):547-554.
[17]Nakano Y,Mizuno T,Niwa T,et al.Impact of Continuous Administration of Tolvaptan on Preventing Medium-Term Worsening Renal Function and Long-Term Adverse Events in Heart Failure Patients with Chronic Kidney Disease[J].Int Heart J,2018,59(1):105-111.
[18]Lawson CA,Testani JM,Mamas M,et al.Chronic kidney disease,worsening renal function and outcomes in a heart failure community setting:A UK national study[J].Int JCardiol,2018,267:120-127.
[19]Huang A,Qi X,Hou W,et al.Prognostic value of sST2 and NT-proBNP at admission in heart failure with preserved,midranged and reduced ejection fraction[J].Acta Cardiol,2018,73(1):41-48.
[20]Jirak P,Fejzic D,Paar V,et al.Influences of Ivabradine treatment on serum levels of cardiac biomarkers sST2,GDF-15,suPAR and H-FABP in patients with chronic heart failure[J].Acta Pharmacol Sin,2018,39(7):1189-1196.
[21]Maisel AS,Di Somma S.Do we need another heart failure biomarker:focus on soluble suppression of tumorigenicity 2(sST2)[J].Eur Heart J,2017,38(30):2325-2333.
[22]Wang EW,Jia XS,Ruan CW,et al.miR-487b mitigates chronic heart failure through inhibition of the IL-33/ST2 signaling pathway[J].Oncotarget,2017,8(31):51688-51702.
[23]De Berardinis B,Gaggin HK,Magrini L,et al.Comparison between admission natriuretic peptides,NGAL and sST2testing for the prediction of worsening renal function in patients with acutely decompensated heart failure[J].Clin Chem Lab Med,2015,53(4):613-621.
[24]Zhang R,Zhang Y,An T,et al.Prognostic value of sST2 and galectin-3 for death relative to renal function in patients hospitalized for heart failure[J].Biomark Med,2015,9(5):433-441.
[25]Ghali R,Altara R,Louch WE,et al.IL-33(Interleukin 33)/sST2(Soluble Suppression of Tumorigenicity 2)Axis in Hypert ension and Heart Failure[J].Hypertension,2018,72(4):818-828.
[26]Veeraveedu PT,Sanada S,Okuda K,et al.Ablation of IL-33gene exacerbate myocardial remodeling in mice with heart failure induced by mechanical stress[J].Biochem Pharmacol,2017,138:73-80.
[2]Valente MA,Hillege HL,Navis G,et al.The Chronic Kidney Disease Epidemiology Collaboration equation outperforms the Modification of Diet in Renal Disease equation for estimating glomerular filtration rate in chronic systolic heart failure[J].Eur J Heart Fail,2014,16(1):86-94.
[3]Hwang H,Chae JB,Kim JY,et al.Changes in Optical Coherence Tomography Findings in Patients with Chronic Renal Failure Undergoing Dialysis for the First Time[J].Retina,2018.[Epub ahead of print]
[4]Keskin G,Babacan Gumus A,Tasdemir Yigitoglu G.Sexual dysfunctions and related variables with sexual function in patients who undergo dialysis for chronic renal failure[J].J Clin Nurs,2019,28(1-2):257-269.
[5]Li JP,Lu L,Wang LJ,et al.Increased serum levels of S100Bare related to the severity of cardiac dysfunction,renal insufficiency and major cardiac events in patients with chronic heart failure[J].Clin Biochem,2011,44(12):984-988.
[6]Nam SJ,Han SH,Kim HW,et al.The cardiac biomarker sodium-calcium exchanger(NCX-1)can differentiate between heart failure and renal failure:a comparative study of NCX-1 expression in dogs with chronic mitral valvular insufficiency and azotemia[J].J Vet Intern Med,2010,24(6):1383-1387.
[7]Park CS,Park JJ,Oh IY,et al.Relation of Renal Function with Left Ventricular Systolic Function and NT-proBNP Level and Its Prognostic Implication in Heart Failure with Preserved versus Reduced Ejection Fraction:an analysis from the Korean Heart Failure(KorHF)Registry[J].Korean Circ J,2017,47(5):727-741.
[8]Zhang J,Wong KY,Clark AL,et al.Exploring the relation between changes in NT-proBNP and renal function in pati ents with suspected heart failure using structural equation modelling[J].Int J Cardiol,2017,233:67-72.
[9]Franekova J,Hoskova L,Secnik P Jr,et al.The role of timely measurement of galectin-3,NT-proBNP,cystatin C and hsTnTin predicting prognosis and heart function after heart transplantation[J].Clin Chem Lab Med,2016,54(2):339-344.
[10]Zhou FJ,Zhou CY,Tian YJ,et al.Diagnostic value of analysis of H-FABP,NT-proBNP,and cTnI in heart function in children with congenital heart disease and pneumonia[J].Eur Rev Med Pharmacol Sci,2014,18(10):1513-1516.
[11]Perez-Downes J,Palacio C,Ibrahim S,et al.Prognostic utility of NT-proBNP greater than 70,000 pg/mL in patients with end stage renal disease[J].J Geriatr Cardiol,2018,15(7):476-478.
[12]Idzerda NMA,Persson F,Pena MJ,et al.N-terminal pro-brain natriuretic peptide(NT-proBNP)predicts the cardio-renal response to aliskiren in patients with type 2 diabetes at high renal and cardiovascular risk[J].Diabetes Obes Metab,2018,20(12):2899-2904.
[13]Gao P,Zhu Q,Bian S,et al.Prognostic value of plasma NT-proBNP levels in very old patients with moderate renal insufficiency in China[J].Z Gerontol Geriatr,2018,51(8):887-894.
[14]Saulnier PJ,Gand E,Velho G,et al.Association of Circulating Biomarkers(Adrenomedullin,TNFR1,and NT-proBNP)With Renal Function Decline in Patients With Type 2 Diabetes:A French Prospective Cohort[J].Diabetes Care,2017,40(3):367-374.
[15]Courand PY,Harbaoui B,Becle C,et al.Plasma NT-proBNPmirrors the deleterious cardiovascular and renal continuum in hypertension[J].Eur J Prev Cardiol,2017,24(5):452-459.
[16]Packer M,Claggett B,Lefkowitz MP,et al.Effect of neprilysin inhibition on renal function in patients with type 2 diabetes and chronic heart failure who are receiving target doses of inhibitors of the renin-angiotensin system:a secondary analysis of the PARADIGM-HF trial[J].Lancet Diabetes Endocrinol,2018,6(7):547-554.
[17]Nakano Y,Mizuno T,Niwa T,et al.Impact of Continuous Administration of Tolvaptan on Preventing Medium-Term Worsening Renal Function and Long-Term Adverse Events in Heart Failure Patients with Chronic Kidney Disease[J].Int Heart J,2018,59(1):105-111.
[18]Lawson CA,Testani JM,Mamas M,et al.Chronic kidney disease,worsening renal function and outcomes in a heart failure community setting:A UK national study[J].Int JCardiol,2018,267:120-127.
[19]Huang A,Qi X,Hou W,et al.Prognostic value of sST2 and NT-proBNP at admission in heart failure with preserved,midranged and reduced ejection fraction[J].Acta Cardiol,2018,73(1):41-48.
[20]Jirak P,Fejzic D,Paar V,et al.Influences of Ivabradine treatment on serum levels of cardiac biomarkers sST2,GDF-15,suPAR and H-FABP in patients with chronic heart failure[J].Acta Pharmacol Sin,2018,39(7):1189-1196.
[21]Maisel AS,Di Somma S.Do we need another heart failure biomarker:focus on soluble suppression of tumorigenicity 2(sST2)[J].Eur Heart J,2017,38(30):2325-2333.
[22]Wang EW,Jia XS,Ruan CW,et al.miR-487b mitigates chronic heart failure through inhibition of the IL-33/ST2 signaling pathway[J].Oncotarget,2017,8(31):51688-51702.
[23]De Berardinis B,Gaggin HK,Magrini L,et al.Comparison between admission natriuretic peptides,NGAL and sST2testing for the prediction of worsening renal function in patients with acutely decompensated heart failure[J].Clin Chem Lab Med,2015,53(4):613-621.
[24]Zhang R,Zhang Y,An T,et al.Prognostic value of sST2 and galectin-3 for death relative to renal function in patients hospitalized for heart failure[J].Biomark Med,2015,9(5):433-441.
[25]Ghali R,Altara R,Louch WE,et al.IL-33(Interleukin 33)/sST2(Soluble Suppression of Tumorigenicity 2)Axis in Hypert ension and Heart Failure[J].Hypertension,2018,72(4):818-828.
[26]Veeraveedu PT,Sanada S,Okuda K,et al.Ablation of IL-33gene exacerbate myocardial remodeling in mice with heart failure induced by mechanical stress[J].Biochem Pharmacol,2017,138:73-80.