Department of Laboratory Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Gangnam-ro, Jinju-si, Gyeongsangnam-do, 52727, Republic of Korea.
Department of Neurology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
Neurol Sci. 2019 Aug;40(8):1597-1605. doi: 10.1007/s10072-019-03873-9. Epub 2019 Apr 13.
Meningitis is an inflammatory process involving meninges. It is difficult to diagnose because of the absence of a diagnostic biomarker. We first report here the possibility of cerebrospinal fluid (CSF) vitamin D-binding protein (VDBP) as a new biomarker for the diagnosis of meningitis.
This prospective study enrolled a total of 102 subjects (58 patients with non-neurologic disease, 17 patients with meningitis, and 27 patients with other neurologic diseases) from 2017 to 2018. CSF and blood samples were collected in pairs. Total 25(OH)D in CSF and serum and VDBP levels in serum were measured. GC genotyping was also performed to determine polymorphisms of rs4588 and rs7041. CSF total 25(OH)D and VDBP levels were compared with serum total 25(OH)D and VDBP levels according to disease (meningitis vs. non-meningitis). Receiver operating characteristic (ROC) analysis for the diagnosis of meningitis using CSF VDBP level was performed.
Mean CSF VDBP and serum VDBP levels of all patients were 1.48 ± 1.32 and 181.28 ± 56.90 μg/mL, respectively. CSF VDBP level in the meningitis disease group (3.20 ± 1.49 μg/mL) was significantly (P < 0.001) higher than that in other disease groups. According to ROC curve analysis, the appropriate cut-off value for CSF VDBP was 1.96 μg/mL, showing sensitivity of 82.4% and specificity of 85.9%. AUC of CSF VDBP was 0.879 (95% CI: 0.789-0.962).
CSF VDBP level showed very good diagnostic performance. It could be used as a potential biomarker for the diagnosis of meningitis.
脑膜炎是一种涉及脑膜的炎症过程。由于缺乏诊断生物标志物，因此很难诊断。我们首次报道脑脊液（CSF）维生素 D 结合蛋白（VDBP）作为脑膜炎诊断的新生物标志物的可能性。
本前瞻性研究共纳入 2017 年至 2018 年的 102 例受试者（58 例非神经疾病患者、17 例脑膜炎患者和 27 例其他神经疾病患者），采集配对的 CSF 和血液样本。测定 CSF 和血清中的总 25（OH）D 和 VDBP 水平，并进行 GC 基因分型以确定 rs4588 和 rs7041 多态性。根据疾病（脑膜炎与非脑膜炎）比较 CSF 总 25（OH）D 和 VDBP 水平与血清总 25（OH）D 和 VDBP 水平。使用 CSF VDBP 水平进行脑膜炎诊断的受试者工作特征（ROC）分析。
所有患者的 CSF VDBP 和血清 VDBP 水平平均值分别为 1.48±1.32μg/mL 和 181.28±56.90μg/mL。脑膜炎疾病组的 CSF VDBP 水平（3.20±1.49μg/mL）明显高于其他疾病组（P<0.001）。根据 ROC 曲线分析，CSF VDBP 的适当截断值为 1.96μg/mL，其敏感性为 82.4%，特异性为 85.9%。CSF VDBP 的 AUC 为 0.879（95%CI：0.789-0.962）。
CSF VDBP 水平具有很好的诊断性能。它可以用作脑膜炎诊断的潜在生物标志物。
