Chou Che-Yi, Tseng Chin-Chung, Chen Jin-Bor, Hung Chin-Chuan, Huang Chiu-Ching
College of Medicine, China Medical University, Taichung, Taiwan.
Division of Nephrology, Asia University Hospital, Taichung, Taiwan.
Biomed Res Int. 2021 Jan 18;2021:6666441. doi: 10.1155/2021/6666441. eCollection 2021.
Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of peritoneal dialysis (PD). So far, there is no biomarker-based prediction tool available for EPS. Matrix metalloproteinase-2 (MMP-2) is a protein involved in the breakdown of the extracellular matrix, and the effluent MMP-2 can be a potential biomarker of EPS. This study is aimed at developing a nomogram for EPS based on effluent MMP-2 levels. . We enrolled 18 EPS patients and 90 gender-matched PD patients without EPS in this cross-sectional case-controlled study. The effluent MMP-2 levels and possible risk factors for EPS were analyzed using multivariable logistic regression, and a nomogram was developed. The nomogram was validated using 200 bootstrap resamples to reduce overfit bias.
The effluent MMP-2 levels in EPS patients were significantly higher than those in normal PD patients ( < 0.001, Manny-Whitney test). Effluent MMP-2 levels and PD duration were independently associated with EPS risks ( < 0.001 and = 0.001) in multivariate logistic regression. A nomogram based on MMP-2 levels and PD duration was proposed. The AUC of MMP-2 was 0.824, and the AUC of the nomogram was 0.907 ( = 0.05).
A nomogram based on effluent MMP-2 levels and PD duration may predict EPS with high accuracy.
包裹性腹膜硬化（EPS）是腹膜透析（PD）一种罕见但严重的并发症。到目前为止，尚无基于生物标志物的EPS预测工具。基质金属蛋白酶-2（MMP-2）是一种参与细胞外基质分解的蛋白质，腹透液中的MMP-2可能是EPS的潜在生物标志物。本研究旨在基于腹透液MMP-2水平开发一种用于预测EPS的列线图。在这项横断面病例对照研究中，我们纳入了18例EPS患者和90例性别匹配的非EPS的PD患者。使用多变量逻辑回归分析腹透液MMP-2水平及EPS的可能危险因素，并绘制列线图。使用200次自抽样重采样对列线图进行验证以减少过度拟合偏差。
EPS患者腹透液中MMP-2水平显著高于正常PD患者（Mann-Whitney检验，P<0.001）。在多变量逻辑回归中，腹透液MMP-2水平和PD持续时间与EPS风险独立相关（P<0.001和P = 0.001）。提出了一种基于MMP-2水平和PD持续时间的列线图。MMP-2的曲线下面积（AUC）为0.824，列线图的AUC为0.907（P = 0.05）。
基于腹透液MMP-2水平和PD持续时间的列线图可能对EPS具有较高的预测准确性。
