Yoon Taejun, Yoon Jiyeol, Ko Eunhee, Park Yong-Beom, Lee Sang-Won
Department of Medical Science, BK21 Plus Project, Yonsei University College of Medicine, Seoul, Korea.
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Korean J Intern Med. 2025 May;40(3):512-523. doi: 10.3904/kjim.2024.254. Epub 2025 Apr 30.
BACKGROUND/AIMS: This study evaluated the clinical utility of serum periostin measured at diagnosis in reflecting activity at diagnosis and predicting all-cause mortality during follow-up in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV).
This study included 76 patients with AAV whose serum periostin was measured from sera collected and stored at diagnosis. The correlation of either serum periostin or the Birmingham Vasculitis Activity Score (BVAS) with other variables was evaluated. Cumulative survival rates were compared using Kaplan-Meier survival analysis. The variables at diagnosis were compared between deceased and surviving patients. Hazard ratios were obtained by Cox proportional hazard analysis.
The median age of the 76 patients was 64.0 years and 60.5% were female. The median BVAS and serum periostin were 5.0 and 10.9 ng/mL, respectively. Five of the 76 patients (6.6%) died. Serum periostin was independently correlated with cross-sectional BVAS, the Vasculitis Damage Index (VDI), white blood cell count, and serum albumin. Patients with serum periostin ≥ 15.9 ng/mL at diagnosis had a significantly lower cumulative survival rate than those without. In addition to high VDI, dyslipidaemia frequency, and C-reactive protein, deceased patients showed higher serum periostin than surviving patients. In multivariable Cox analysis, however, only dyslipidaemia rather than serum periostin was identified as an independent predictor of all-cause mortality.
This study is the first to demonstrate that serum periostin at diagnosis could independently reflect cross-sectional BVAS and further partially contribute to all-cause mortality prediction in patients with AAV.
背景/目的：本研究评估了抗中性粒细胞胞浆抗体相关性血管炎（AAV）患者诊断时检测的血清骨膜蛋白在反映诊断时的疾病活动度以及预测随访期间全因死亡率方面的临床效用。
本研究纳入了76例AAV患者，这些患者的血清骨膜蛋白是通过诊断时采集并储存的血清进行检测的。评估了血清骨膜蛋白或伯明翰血管炎活动评分（BVAS）与其他变量之间的相关性。采用Kaplan-Meier生存分析比较累积生存率。比较了死亡患者和存活患者诊断时的变量。通过Cox比例风险分析获得风险比。
76例患者的中位年龄为64.0岁，60.5%为女性。中位BVAS和血清骨膜蛋白分别为5.0和10.9 ng/mL。76例患者中有5例（6.6%）死亡。血清骨膜蛋白与横断面BVAS、血管炎损伤指数（VDI）、白细胞计数和血清白蛋白独立相关。诊断时血清骨膜蛋白≥15.9 ng/mL的患者累积生存率显著低于未达到该水平的患者。除了高VDI、血脂异常发生率和C反应蛋白外，死亡患者的血清骨膜蛋白高于存活患者。然而，在多变量Cox分析中，只有血脂异常而非血清骨膜蛋白被确定为全因死亡率的独立预测因素。
本研究首次表明，诊断时的血清骨膜蛋白可独立反映横断面BVAS，并在一定程度上有助于预测AAV患者的全因死亡率。
