Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
Biol Trace Elem Res. 2021 Mar;199(3):895-911. doi: 10.1007/s12011-020-02219-3. Epub 2020 Jun 5.
Acute aortic dissection (AAD), one of the fatal diseases observed at the department of vascular surgery, is associated with a great mortality rate at the early stage. Ceruloplasmin (CP) is the plasma protein that functions as a copper transporter. The current retrospective research was carried out to assess CP contents and to examine the possible part in diagnosing patients with AAD. In addition, propensity score matching (PSM) was also utilized for reducing the bias in case screening as well as the clinical confounders. Using PSM, this study included 85 pairs of AAD cases (Stanford A and B dissection) and matched controls, and their CP levels were also detected through enzyme-linked immunosorbent assay (ELISA). Additionally, the relative clinical data were extracted from participants included in this study. After PSM adjustment for clinical variables, including gender, age, body mass index (BMI), heart ratio (HR), smoking, hypertension, diabetes mellitus, coronary heart disease (CHD), and stroke, the serum CP contents among AAD cases were remarkably increased compared with those among the normal subjects. Besides, the CP contents showed independent association with the AAD risk. Typically, the CP level was significantly positively correlated with platelet (R = 0.329) or C-reactive protein (R = 0.340) level. Meanwhile, the area under the receiver operating characteristic (ROC) curve (AUC) was 0.929 when CP was used to diagnose AAD, and the best threshold value was 36.82mg/dL. Serum CP content significantly increased in cases with thrombosed false lumen (FL) relative to those in patent FL cases. Results of logistic regression analysis suggested that a greater CP content indicated an increased thrombosed FL risk (OR = 1.11; 95% CI: 1.01-1.23; P = 0.040). Findings in this study suggest that serum ceruloplasmin contents evidently increased among acute aortic dissection cases. CP shows close correlation with the inflammatory factors among AAD cases. Further, CP may serve as the candidate biomarker to diagnose AAD and to identify an increased risk of thrombosed false lumen.
急性主动脉夹层（AAD）是血管外科观察到的致命疾病之一，其在早期的死亡率很高。铜蓝蛋白（CP）是一种作为铜转运蛋白的血浆蛋白。本回顾性研究旨在评估 CP 含量，并探讨其在诊断 AAD 患者中的可能作用。此外，还采用倾向评分匹配（PSM）来减少病例筛选和临床混杂因素的偏倚。通过 PSM，本研究纳入了 85 对 AAD 病例（Stanford A 和 B 夹层）和匹配对照，并通过酶联免疫吸附试验（ELISA）检测其 CP 水平。此外，还从本研究纳入的参与者中提取了相关的临床数据。在 PSM 调整了性别、年龄、体重指数（BMI）、心脏比值（HR）、吸烟、高血压、糖尿病、冠心病（CHD）和中风等临床变量后，AAD 病例的血清 CP 含量明显高于正常对照组。此外，CP 含量与 AAD 风险呈独立相关。通常，CP 水平与血小板（R=0.329）或 C 反应蛋白（R=0.340）水平呈显著正相关。同时，CP 用于诊断 AAD 的受试者工作特征（ROC）曲线下面积（AUC）为 0.929，最佳阈值为 36.82mg/dL。与有通畅假腔（FL）的病例相比，血栓形成的 FL 病例的血清 CP 含量显著增加。Logistic 回归分析结果表明，CP 含量较高表明血栓形成的 FL 风险增加（OR=1.11；95%CI：1.01-1.23；P=0.040）。本研究结果表明，急性主动脉夹层病例的血清铜蓝蛋白含量明显升高。CP 与 AAD 病例中的炎症因子密切相关。此外，CP 可能作为诊断 AAD 和识别血栓形成的假腔风险增加的候选生物标志物。
