El Moneem Elfedawy Maha Abd, El Sadek Elsebai Samia Abd, Tawfik Hend Mohamed, Youness Eman Refaat, Zaki Moushira
Department of Internal Medicine, Faculty of Medicine, Al-Azher University (for girls), Egypt.
Medical Biochemistry Department, Medical Research and Clinical Studies Institute - National Research Centre Cairo, Egypt.
J Genet Eng Biotechnol. 2024 Dec;22(4):100438. doi: 10.1016/j.jgeb.2024.100438. Epub 2024 Nov 20.
Chronic kidney disease (CKD) is a chief worldwide health concern that has a substantial financial impact on health systems, high rates of mortality and morbidity as well as cardiovascular disease (CVD) is a major cause of mortality in this population. Adropin is a unique hormone encoded by the energy homeostasis-associated (Enho) gene.
We aimed to explore the efficacy of adropin as a diagnostic candidate biomarker for CVD in patients with CKD.
This is prospective study was carried out on 60 patients (Pt) with CKD and 30 age and sex matched healthy control subjects. CKD Pt were classified according to the history of CVD into two groups: Group A, Pt without history (n = 32) and Group B, Pt with history (n = 28). Serum adropin, lipids and Hs-CRP were measured by ELISA kit. Echocardiography was also investigated. Receiver operator characteristic curve (ROC) was used to determine cut-off points of adropin. Negative predict value (NPV), negative predict value (NPV) and area under curve were detected.
There were abnormal ECGs in 78.6 % of CKD patients. Adropin was significantly decreased in Group B than Group A and control group. On the other hand, serum lipids and Hs-CRP were significantly increased in Group B than Group A and control group. ROC analysis revealed that serum adropin could be used to discriminate between patients with and without CVD history at a cutoff level of > 304 with 46.4 % sensitivity and 84.4 % specificity, 74.8 % PPV, 61.2 % NPV and AUC = 0.57. Moreover, between Group A and control at a cutoff level of < 410, with 93.8 % sensitivity, 86.7 % specificity, 87.6 % PPV and 93.3 % NPV and AUC = 0.97 as well as between Group B and control group at a cutoff level of < 416, with 57.1 % sensitivity, 83.3 % specificity, 77.4 % PPV and 66 % NPV and AUC = 0.65.
Particularly in CKD patients, adropin may be a useful biomarker for predicting the onset of CVD. Adropin may represent a novel and useful blood marker for assessing systolic function and Spontaneous coronary artery dissection (SCAD).
慢性肾脏病(CKD)是全球主要的健康问题,对卫生系统造成巨大经济影响,其死亡率和发病率很高,心血管疾病(CVD)是该人群死亡的主要原因。内脂素是一种由能量稳态相关(Enho)基因编码的独特激素。
我们旨在探讨内脂素作为CKD患者CVD诊断候选生物标志物的有效性。
本前瞻性研究对60例CKD患者和30例年龄及性别匹配的健康对照者进行。CKD患者根据CVD病史分为两组:A组,无CVD病史患者(n = 32);B组,有CVD病史患者(n = 28)。采用酶联免疫吸附测定试剂盒检测血清内脂素、血脂和超敏C反应蛋白(Hs-CRP)。还进行了超声心动图检查。采用受试者工作特征曲线(ROC)确定内脂素的截断点。检测阴性预测值(NPV)、阳性预测值(PPV)和曲线下面积。
78.6%的CKD患者心电图异常。B组内脂素水平显著低于A组和对照组。另一方面,B组血清血脂和Hs-CRP水平显著高于A组和对照组。ROC分析显示,血清内脂素可用于区分有无CVD病史的患者,截断水平>304时,敏感性为46.4%,特异性为84.4%,PPV为74.8%,NPV为61.2%,AUC = 0.57。此外,A组与对照组比较,截断水平<410时,敏感性为93.8%,特异性为86.7%,PPV为87.6%,NPV为93.3%,AUC = 0.97;B组与对照组比较,截断水平<416时,敏感性为57.1%,特异性为83.3%,PPV为77.4%,NPV为66%,AUC = 0.65。
特别是在CKD患者中,内脂素可能是预测CVD发病的有用生物标志物。内脂素可能是评估收缩功能和自发性冠状动脉夹层(SCAD)一种新的有用的血液标志物。