Xi Rui, Fan Qin, Yan Xiaoxiang, Zhang Hang, Xie Hongyang, Gu Gang, Xu Yan, Wang Fang, Tao Rong
Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Physiol. 2018 Jul 11;9:904. doi: 10.3389/fphys.2018.00904. eCollection 2018.
Several inflammatory factors have been demonstrated with diagnostic or prognostic value in patients with ischemic cardiomyopathy (ICM). Interleukin 34 (IL-34), an additional ligand of colony stimulating factor-1 receptor (CSF-1R), has been identified as a biomarker of coronary artery disease (CAD) and chronic kidney disease (CKD). However, the potential effect of IL-34 in ICM remains unknown. Serum IL-34 levels were detected in 360 subjects with ICM and in 465 subjects without ICM; the latter group included 233 controls without CAD and 232 patients with CAD and normal cardiac function. Uni- and multivariable logistic regression analyses were conducted to analyze the relationship between IL-34 and ICM. IL-34 levels were significantly increased in patients with ICM compared with both groups of subjects without ICM (122.52 ± 115.30 vs. 95.02 ± 101.43 vs. 82.57 ± 84.24 pg/ml, respectively; < 0.001). Moreover, serum IL-34 level was significantly positively correlated to NT-proBNP level ( = 0.223, < 0.001), left ventricular end diastolic diameter and New York Heart Association (NYHA) functional class, indicating that a higher IL-34 level reflects more severe heart failure (HF). Multivariable regression analyses revealed that IL-34 was remarkably associated with the presence and severity of ICM after adjusting for age, sex, conventional risk factors as well as medication [odds ratio (OR): 1.501, 95% confidence interval (CI): 1.249-1.803, < 0.001, per SD increase]. The predictive value of IL-34 value remained significant in patients already diagnosed with CAD. Increased IL-34 levels are relevant to the presence and severity of ischemic HF in all subjects and in patients with CAD. IL-34 may be used as a novel clinical biomarker of ICM with predictive value.
在缺血性心肌病（ICM）患者中，几种炎症因子已被证明具有诊断或预后价值。白细胞介素34（IL-34）是集落刺激因子-1受体（CSF-1R）的另一种配体，已被确定为冠状动脉疾病（CAD）和慢性肾脏病（CKD）的生物标志物。然而，IL-34在ICM中的潜在作用仍不清楚。检测了360例ICM患者和465例非ICM患者的血清IL-34水平；后一组包括233例无CAD的对照者和232例有CAD且心功能正常的患者。进行单变量和多变量逻辑回归分析以分析IL-34与ICM之间的关系。与两组非ICM患者相比，ICM患者的IL-34水平显著升高（分别为122.52±115.30 vs. 95.02±101.43 vs. 82.57±84.24 pg/ml；<0.001）。此外，血清IL-34水平与NT-proBNP水平显著正相关（=0.223，<0.001），与左心室舒张末期直径和纽约心脏协会（NYHA）功能分级显著正相关，表明较高的IL-34水平反映更严重的心力衰竭（HF）。多变量回归分析显示，在调整年龄、性别、传统危险因素以及药物治疗后，IL-34与ICM的存在和严重程度显著相关[比值比（OR）：1.501，95%置信区间（CI）：1.249-1.803，<0.001，每增加1个标准差]。在已诊断为CAD的患者中，IL-34值的预测价值仍然显著。IL-34水平升高与所有受试者以及CAD患者中缺血性HF的存在和严重程度相关。IL-34可作为具有预测价值的ICM新型临床生物标志物。
