The diagnostic value of GDF-15 for myocardial involvement in idiopathic inflammatory myopathy.
The diagnostic value of GDF-15 for myocardial involvement in idiopathic inflammatory myopathy.
复制标题
DOI：
10.1093/rheumatology/keaa721
复制
发表时间：
2020-11
期刊：
影响因子：
5.5
通讯作者：
M. Qiu;Xiaoxuan Sun;Xiaoqing Qi;Xianfang Liu;Yue Zhang;Ning Zhang;F. Lu;Wangyan Liu;Changjing Feng;Qiang Wang;Lei Zhou
中科院分区：
文献类型：
--
作者：
M. Qiu;Xiaoxuan Sun;Xiaoqing Qi;Xianfang Liu;Yue Zhang;Ning Zhang;F. Lu;Wangyan Liu;Changjing Feng;Qiang Wang;Lei Zhou
背景心脏受累是特发性炎性肌病（IIM）的严重并发症。GDF-15可以预测心血管疾病的风险和预后，但其在IIM中的价值尚不清楚。目的探讨GDF-15对IIM心肌损害的诊断价值。方法回顾性研究2018年5月至2020年8月期间共纳入77例IIM患者。其中，43例患者接受了心脏磁共振（CMR）检查。SLE患者33例，健康对照组16例。通过ELISA测量这些组的GDF-15浓度。结果IIM组、SLE组和健康对照组GDF-15水平差异有显著性（H = 45.291，P <0.001）。有心肌损伤组GDF-15水平为1484.88（809.07 ± 2835.50）pg/ml，无心肌损伤组为593.26（418.61 ± 784.59）pg/ml，差异有统计学意义（P = 0.001）。在调整年龄、肾功能后，IIM患者中每增加一个单位的GDF-15，心肌损伤的风险平均增加0.3%（比值比= 1.003，95%CI：1.000，1.007）。GDF-15水平与细胞外容积（ECV）呈正相关（rs = 0.348，P = 0.028）。GDF-15 ≥ 929.505 pg/ml（曲线下面积= 0.856，95% CI：0.744，0.968）预测IIM心肌损伤的敏感性为0.75，特异性为0.90。结论GDF-15可作为预测IIM患者心肌损伤的潜在生物标志物。
BACKGROUND Cardiac involvement is a serious complication of idiopathic inflammatory myopathy (IIM). GDF-15 can predict the risk and the prognosis of cardiovascular disease, but its value is unclear in IIM. OBJECTIVE To investigate the diagnostic value of GDF-15 for myocardial involvement in IIM. METHODS A total of 77 IIM patients from May 2018 to August 2020 were included in this retrospective study. Of these, 43 patients underwent cardiac magnetic resonance (CMR) examination. There were 33 SLE patients and 16 healthy people were used as the control group. The concentration of GDF-15 of these groups was measured by ELISA. RESULTS There were significant differences in GDF-15 levels in patients with IIM, SLE and healthy controls (H = 45.291, P<0.001). GDF-15 levels were statistically significant different between IIM patients with the myocardial injury [1484.88(809.07 2835.50) pg/ml] and without myocardial injury [593.26(418.61 784.59) pg/ml, P =0.001]. After adjusted for age, renal function, the risk of myocardial injury in IIM patients increased an average of 0.3% by per increased unit of GDF-15 (odds ratio=1.003, 95% CI: 1.000, 1.007). The level of GDF-15 was positively correlated with extra-cellular volume (ECV) (rs = 0.348, P =0.028). GDF-15 ≥ 929.505 pg/ml (area under the curve=0.856, 95% CI: 0.744, 0.968) predicted myocardial injury in IIM with a sensitivity of 0.75 and specificity of 0.90. CONCLUSION GDF-15 could serve as a potential biomarker to predict myocardial injury in IIM patients.