Lin Yingying, Li Yanyan, Cui Xinyu, Zhu Na, Li Xin
Department of Center of Integrated Traditional Chinese and Western Medicine, Peking University Ditan Teaching Hospital, Beijing, People's Republic of China.
Department of Center of Integrated Traditional Chinese and Western Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People's Republic of China.
J Inflamm Res. 2024 Dec 30;17:11829-11843. doi: 10.2147/JIR.S499326. eCollection 2024.
Hyaluronic acid (HA) is a novel inflammatory biomarker with a prognostic value for several infectious diseases. This study investigated the association of HA with severity and prognosis in hospitalized patients with community-acquired pneumonia (CAP).
We analyzed the differences of HA levels in different groups. Logistic regression analysis was performed to identify independent risk factors for severe CAP (SCAP). The predictive value of HA for SCAP was assessed using receiver operating characteristic (ROC) curves. Kaplan-Meier survival analysis was used to compare 30-day mortality between the high and low HA groups.
Compared to healthy controls (49.2 ± 15.3 ng/mL), patients with CAP exhibited significantly elevated levels of HA (P < 0.001). In CAP patients, increased HA levels were more pronounced in those with SCAP (SCAP vs non-SCAP:135.6 ± 51 ng/mL vs 100.7 ± 47.8 ng/mL, P < 0.001). Compared to survivors (109.9 ± 48.7 ng/mL), HA levels in non-survivors were significantly higher (180.9 ± 67.8 ng/mL) (P < 0.001). HA was an independent predictor of SCAP [odds ratio (OR): 1.013, 95% confidence interval (CI): 1.003-1.022, P = 0.011] with high diagnostic accuracy [areas under the curve (AUC): 0.709, 95% CI: 0.622-0.797, P = 0.001]. Additionally, HA was independently associated with death risk in patients with CAP (OR: 1.022, 95% CI: 1.005-1.039, P = 0.010). Kaplan-Meier survival curves indicated that CAP patients in the high HA group exhibit a higher 30-day mortality rate compared to those in the low HA group (8.6% vs 1.5%, P = 0.008). Post hoc analysis indicated that our study possessed 98.857% statistical power.
In conclusion, High HA levels are associated with severity and mortality in patients with CAP, and HA could serve as a novel serum biomarker to predict the risk of CAP progression.
透明质酸（HA）是一种新型炎症生物标志物，对多种传染病具有预后价值。本研究调查了HA与社区获得性肺炎（CAP）住院患者的严重程度和预后之间的关系。
我们分析了不同组中HA水平的差异。进行逻辑回归分析以确定重症CAP（SCAP）的独立危险因素。使用受试者工作特征（ROC）曲线评估HA对SCAP的预测价值。采用Kaplan-Meier生存分析比较高HA组和低HA组的30天死亡率。
与健康对照组（49.2±15.3 ng/mL）相比，CAP患者的HA水平显著升高（P<0.001）。在CAP患者中，SCAP患者的HA水平升高更为明显（SCAP组与非SCAP组：135.6±51 ng/mL对100.7±47.8 ng/mL，P<0.001）。与幸存者（109.9±48.7 ng/mL）相比，非幸存者的HA水平显著更高（180.9±67.8 ng/mL）（P<0.001）。HA是SCAP的独立预测因子[比值比（OR）：1.013，95%置信区间（CI）：1.003 - 1.022，P = 0.011]，诊断准确性高[曲线下面积（AUC）：0.709，95% CI：0.622 - 0.797，P = 0.001]。此外，HA与CAP患者的死亡风险独立相关（OR：1.022，95% CI：1.005 - 1.039，P = 0.010）。Kaplan-Meier生存曲线表明，高HA组的CAP患者30天死亡率高于低HA组（8.6%对1.5%，P = 0.008）。事后分析表明我们的研究具有98.857%的统计效能。
总之，高HA水平与CAP患者的严重程度和死亡率相关，HA可作为预测CAP进展风险的新型血清生物标志物。
