Value of plasma metabolite palmitic acid to the diagnosis of acute Stanford type B aortic dissection
Objective To observe the changes of plasma palmitic acid level in patients with acute Stanford type B aortic dissection(TBAD)and to explore its value to the diagnosis of TBAD.Methods Thirty patients with acute TBAD(TBAD group)and 30 healthy volunteers(control group)were diagnosed and treated in the First Affiliated Hospital of Xinjiang Medical University from January 2022 to July 2023.The plasma metabolite palmitic acid was detected,and the clinical data as fasting plasma glucose and urea were compared between two groups.Pearson correlation analysis was done to assess the correlations of plasma palmitic acid level with the clinical indicators such as descending aortic diameter and procalcitonin.ROC curves were plotted to evaluate the efficiencies of palmitic acid and D-dimer on diagnosing TBAD.Results The fasting plasma glucose,urea,total bilirubin,D-dimer,C-reactive protein,interleukin-6,procalcitonin,palmitic acid and descending aortic diameter were higher in TBAD group[(7.08±2.50)mmol/L,(6.36±2.90)mmol/L,(21.29±10.33)μmol/L,1 616.50(805.50,4 828.00)μg/L,25.90(7.10,58.53)mg/L,36.17(20.18,82.88)ng/L,0.05(0.03,0.13)μg/L,(4.35±1.08)g/mL,(36.53±4.10)mm]than those in control group[(6.03±0.96)mmol/L,(5.02±1.08)mmol/L,(8.62±4.96)μmol/L,(122.50(62.00,200.00)μg/L,5.60(2.55,7.90)mg/L,3.20(2.45,4.20)ng/L,0.03(0.02,0.04)μg/L,(2.56±0.67)g/mL,(25.83±3.31)mm](t=2.163,2.376,6.056,Z=-6.247,-4.488,-6.654,-2.774,t=7.680,11.119;all P values＜0.05).The direct bilirubin level was lower in TBAD group[(0.40±0.08)μmol/L]than that in control group[(3.02±1.85)μmol/L](t=-7.712,P＜0.001).The ascending aortic diameter was shorter in TBAD group[(20.63±2.01)mm]than that in control group[(28.87±5.94)mm](t=-7.197,P＜0.001).The level of plasma palmitic acid was positively correlated with the descending aortic diameter,procalcitonin,inteleukin-6,C-reactive protein,D-dimer and fasting plasma glucose(r=0.563,0.330,0.495,0.188,0.287,0.347;all P values＜0.05),and negatively correlated with the ascending aortic diameter and direct bilirubin(r=-0.544,P＜0.001;r=-0.552,P＜0.001).When the optimal cut-off values of plasma palmitic acid and D-dimer were 3.685 g/mL and 247 μg/L,the AUCs for predicting TBAD were 0.932(95％CI:0.872-0.992,P＜0.001),0.969(95％CI:0.926-0.999,P＜0.001),and 0.993(95％CI:0.980-0.999,P＜0.001),the sensitivities were 76.7％,93.3％and 96.7％,and the specificities were 96.7％,93.3％and 96.7％,respectively.Conclusion The plasma palmitic acid level elevates in acute TBAD patients,and the combination of plasma palmitic acid and D-dimer has a high value to the diagnosis of acute TBAD.
acute Stanford type B aortic dissectionpalmitic acidD-dimer
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