Zhang Mingle, Li Gaoshan, Li Kunyan, Gao Zhichun, Yin Chun, Zeng Fangzheng, Yang Hao, Dong Wang, Zhou Guiquan, Pan Wenxu, Wang Ying, Jin Jun
Department of Cardiology, The Second Affiliated Hospital (Xinqiao Hospital) of Army Medical University, Chongqing, 400037, China.
School of Medicine, Chongqing University, Chongqing, 400044, China.
Heliyon. 2024 Aug 12;10(16):e35905. doi: 10.1016/j.heliyon.2024.e35905. eCollection 2024 Aug 30.
Secreted frizzled-related protein 5 (SFRP5) is a novel adipokine that has been found to be closely associated with metabolic and cardiovascular diseases. We investigated serum SFRP5 levels during the acute phase and their predictive value for the prognosis of acute aortic dissection (AAD).
In total, 152 AAD patients and 164 controls were enrolled in this study. Serum SFRP5 levels were measured using an enzyme-linked immunosorbent assay (ELISA). AAD patients were divided into high-SFRP5 and low-SFRP5 groups based on the optimal cutoff value and followed up for prognosis. The primary endpoint was all-cause mortality, and the secondary endpoint focused on AAD-related events (including AAD-related mortality and unplanned reoperations).
Serum SFRP5 levels were significantly higher in AAD patients than in non-AAD controls, regardless of whether they had Stanford type A or B AD. Multivariate logistic regression analysis revealed an independent association between SFRP5 and the presence of AAD (adjusted OR 1.267, 95 % CI 1.152-1.394; < 0.001). The receiver operating characteristic curve demonstrated that the optimal cutoff value for SFRP5 to predict the presence of AAD was 10.26 ng/mL (AUC 0.7241, sensitivity 49.34 %, specificity 87.20 %). Notably, serum SFRP5 levels of patients in the death group were significantly higher than those in the survival group. Compared with patients in the low-SFRP5 group, those in the high-SFRP5 group exhibited a significantly increased risk of all-cause mortality (HR 9.540, 95 % CI 2.803-32.473; < 0.001) and AAD-related events (HR 6.915, 95 % CI 2.361-20.254; < 0.001) during the follow-up period.
Serum SFRP5 levels were significantly elevated in the acute phase of AAD, and high serum SFRP5 levels were independently associated with poor AAD prognosis. These results suggest that serum SFRP5 level during the acute phase may be an effective biomarker and therapeutic target for the prognosis of AAD.
分泌型卷曲相关蛋白5（SFRP5）是一种新型脂肪因子，已发现其与代谢和心血管疾病密切相关。我们研究了急性期血清SFRP5水平及其对急性主动脉夹层（AAD）预后的预测价值。
本研究共纳入152例AAD患者和164例对照。采用酶联免疫吸附测定（ELISA）法检测血清SFRP5水平。根据最佳临界值将AAD患者分为高SFRP5组和低SFRP5组，并对其预后进行随访。主要终点为全因死亡率，次要终点聚焦于AAD相关事件（包括AAD相关死亡率和非计划再次手术）。
无论AAD患者是斯坦福A型还是B型，其血清SFRP5水平均显著高于非AAD对照。多因素逻辑回归分析显示SFRP5与AAD的存在独立相关（校正OR 1.267，95%CI 1.152 - 1.394；<0.001）。受试者工作特征曲线表明，SFRP5预测AAD存在的最佳临界值为10.26 ng/mL（AUC 0.7241，敏感性49.34%，特异性87.20%）。值得注意的是，死亡组患者的血清SFRP5水平显著高于存活组。与低SFRP5组患者相比，高SFRP5组患者在随访期间全因死亡率（HR 9.540，95%CI 2.803 - 32.473；<0.001）和AAD相关事件（HR 6.915，95%CI 2.361 - 20.254；<0.001）的风险显著增加。
AAD急性期血清SFRP5水平显著升高，高血清SFRP5水平与AAD预后不良独立相关。这些结果表明，急性期血清SFRP5水平可能是AAD预后的有效生物标志物和治疗靶点。
