首页|β-珠蛋白生成障碍性贫血患者血清FABP4,FGF19水平表达及与预后的关系

β-珠蛋白生成障碍性贫血患者血清FABP4,FGF19水平表达及与预后的关系

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目的 研究β-珠蛋白生成障碍性贫血(beta-thalassaemia,β-TM)患者血清脂肪酸结合蛋白4(fatty acid-binding protein 4,FABP4)、纤维细胞生长因子19(fibroblast growth factor 19,FGF19)表达及其与预后的关系.方法 选取2018年1月~2020年8月重庆大学附属黔江医院诊治的112例β-珠蛋白生成障碍性贫血患者为病例组,选取同期体检的60例健康人为对照组.采用酶联免疫吸附实验(ELISA)检测血清FABP4和FGF19水平.Logistic回归模型分析β-珠蛋白生成障碍性贫血患者预后影响因素.受试者工作特征(ROC)曲线分析血清FABP4和FGF19对β-珠蛋白生成障碍性贫血患者预后的预测价值.结果 病例组患者血清FABP4(67.13±11.35 μg/L)水平高于对照组(22.01±4.16μg/L),血清 FGF19(104.24±21.46 ng/L)水平低于对照组(218.01±36.79 ng/L),差异均具有统计学意义(t=29.708,25.620,均P<0.05).轻型组、中间型组及重型组患者血清FABP4水平(54.20±12.63 μg/L,66.83±10.5μg/L,79.72±11.05μg/L)依次升高,而 FGF19 水平(122.53±22.36 ng/L,103.16±20.37 ng/L,86.53±18.14 ng/L)依次降低,差异具有统计学意义(F=39.701,24.231,均P<0.05).相比于生存组,死亡组患者血清FGF19(62.80±22.09 ng/L vs 110.16±20.69 ng/L),血红蛋白、杂合子基因型比例(βCD17/βN,βCD41-42/βN)较低,而血清FABP4(116.69±12.30 ng/L vs 60.05±10.17 ng/L),铁蛋白及心脏增大比例较高,差异具有统计学意义(t/x2=4.436~18.981,均 P<0.05).FGF19(OR=0.634,95%CI:0.451~0.891)是 β-珠蛋白生成障碍性贫血患者预后的独立保护因素(P<0.001),血清FABP4(OR=1.840,95%CI:1.193~2.838)为预后独立危险因素(P<0.001).血清FABP4,FGF19联合对β-珠蛋白生成障碍性贫血患者预后评估的曲线下面积(95%CI)为0.897(0.853~0.951),大于单指标检测 0.842(0.801~0.879)和 0.814(0.762~0.858),差异具有统计学意义(Z=4.864,5.270,P=0.002,0.001).结论 β-珠蛋白生成障碍性贫血患者血清FABP4升高,FGF19降低.血清FABP4,FGF19联合检测对-珠蛋白生成障碍性贫血患者预后具有较高的预测价值.
Expression of Serum FABP4 and FGF19 Levels in Patients with β-Thalassemia and Their Relationship with Prognosis
Objective To explore the expression of serum fatty acid-binding protein 4(FABP4)and fibroblast growth factor 19(FGF19)in patients with β-thalassemia and their relationship with clinical prognosis.Methods A total of 112 cases ofβ-thalassemia patients diagnosed and treated in Qianjiang Hospital Affiliated to Chongqing University from January 2018 to August 2020 were selected as the case group,and 60 healthy individuals who underwent physical examinations during the same period were taken as the control group.Enzyme-linked immunosorbent assay was used to detect levels of serum FABP4 and FGF19 expression.Multivariate logistic regression analysis was used to analyze factors affecting the prognosis of patients with β-thalassemia.Receiver operating characteristic curve was used to analyze the prognostic value of FABP4 and FGF19 in patients with β-thalassemia.Results The serum FABP4 level(67.13±11.35 μg/L)in the case group was higher than that in the control group(22.01±4.16μg/L),while the serum FGF19 level(104.24±21.46 ng/L)was lower than that in the control group(218.01±36.79 ng/L),with significant differences(t=29.708,25.620,all P<0.05).The serum FABP4 levels(54.20±12.63 μ g/L,66.83±10.5 μ g/L,79.72±11.05 μ g/L)in the mild group,intermediate group,and severe group were increased sequentially,while FGF19 levels(122.53±22.36 ng/L,103.16±20.37 ng/L,86.53±18.14 ng/L)were decreased sequentially,and the differences were significant(F=39.701,24.231,all P<0.05).Compared to the survival group,serum FGF19 level(62.80±22.09 ng/L vs 110.16±20.69 ng/L),Hb and the proportion of heterozygous genotypes in the death group patients(β CD17/β N,β CD41-42/β N)was lower,while serum FABP4(116.69±12.30 ng/L vs 60.05±10.17 ng/L),ferritin and the proportion of cardiac enlargement were higher,with significant differences(t/x2=4.436~18.981,all P<0.05).FGF19(OR=0.634,95%CI:0.451~0.891)was an independent protective factor for β-thalassemia patients(P<0.001),and serum FABP4(OR=1.840,95%CI:1.193~2.838)was an independent risk factor for prognosis(P<0.001).The area under the curve(95%CI)of serum FABP4 and FGF19 combination in prognosis evaluation for β-thalassemia patients was 0.897(0.853~0.951),which was greater than the single serum indicator detection of 0.842(0.801~0.879)and 0.814(0.762~0.858),with significant differences(Z=4.864,5.270,P=0.002,0.001).Conclusion The serum FABP4 expression is increased,but serum FGF19 expression is decreased in patients with β-thalassemia.The combination of serum FABP4 and FGF19 may have a high predictive value for the prognosis of patients with β-thalassemia.

β-thalassemiafatty acid-binding protein 4fibroblast growth factor 19

陈艺心、潘锋、徐娅、彭鑫、梁露、李茹靖、李聪、曾红鑫

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重庆大学附属黔江医院输血科,重庆 409000

重庆大学附属黔江医院检验科,重庆 409000

β-珠蛋白生成障碍性贫血 脂肪酸结合蛋白4 纤维细胞生长因子19

重庆市卫生健康委员会医学科研项目吉首大学指导性项目黔江区科技计划项目

2022WSJK016Jdzd23026黔科技2024009

2024

现代检验医学杂志
陕西省临床检验中心,陕西省人民医院

现代检验医学杂志

CSTPCD
影响因子:0.713
ISSN:1671-7414
年,卷(期):2024.39(5)