Variability of biomarkers in patients with chronic heart failure and healthy controls.
Variability of biomarkers in patients with chronic heart failure and healthy controls.
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DOI：
10.1002/ejhf.669
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发表时间：
2017-03
影响因子：
18.2
通讯作者：
de Boer RA
中科院分区：
文献类型：
--
作者：
Meijers WC;van der Velde AR;Muller Kobold AC;Dijck-Brouwer J;Wu AH;Jaffe A;de Boer RA
生物标志物可用于心衰（HF）患者的诊断、风险分层或管理。关于生物变异的知识是正确解释系列测量的必要条件。因此，我们的目的是确定和比较健康受试者和慢性心衰患者中大量生物标志物的生物学变化。在4个月和6周的时间里，分别在28名健康受试者和83名HF患者中测定了已建立的生物标志物[NT‐proBNP和高敏感性肌钙蛋白T (hsTnT)]、新生物标志物[凝集素‐3、抑制致瘤性2 （ST2）和生长分化因子15 (GDF‐15)]和肾/神经激素生物标志物（醛固酮、磷酸盐、甲状旁腺激素、血浆肾素浓度和肌酐）的生物学变异性。计算了分析（CVa）、个体内（CVi）和个体间（CVg）的变化，以及参考变化值（RCV），它反映了可能表明“相关”变化的变化百分比。与对照组相比，HF患者所有粗生物标志物水平均显著升高或降低（均P < 0.01）。健康人与心衰患者的变异指数具有可比性。CVi不受生物标志物本身的个体水平的影响。NT‐proBNP和GDF‐15具有相对较高的CVi（21.8%和16.6%）和RCV(61.7%和64.3%)，而ST2 （CVi, 15.0； RCV, 42.9%）、hsTnT （CVi, 11.1； RCV, 31.4%）和galectin‐3 （CVi, 8.1； RCV, 25.0%）的变异指数较低。在广泛的生物标志物方面，健康人与心衰患者的生物变异指数具有可比性。NT‐proBNP和GDF‐15的变异较大，而ST2、hsTnT和galectin‐3的变异较小。这些数据有助于正确解释心衰患者的生物标志物水平。
Biomarkers can be used for diagnosis, risk stratification, or management of patients with heart failure (HF). Knowledge about the biological variation is needed for proper interpretation of serial measurements. Therefore, we aimed to determine and compare the biological variation of a large panel of biomarkers in healthy subjects and in patients with chronic HF. The biological variability of established biomarkers [NT‐proBNP and high‐sensitivity troponin T (hsTnT)], novel biomarkers [galectin‐3, suppression of tumorigenicity 2 (ST2), and growth differentiation factor 15 (GDF‐15)], and renal/neurohormonal biomarkers (aldosterone, phosphate, parathyroid hormone, plasma renin concentration, and creatinine) was determined in 28 healthy subjects and 83 HF patients, over a period of 4 months and 6 weeks, respectively. The analytical (CVa), intraindividual (CVi), and interindividual (CVg) variations were calculated, as well as the reference change value (RCV), which reflects the percentage of change that may indicate a ‘relevant’ change. All crude biomarker levels were significantly increased or decreased in HF patients compared with controls (all P < 0.01). Variation indices were comparable in healthy individuals and HF patients. CVi was not influenced by the individual levels of the biomarker itself. NT‐proBNP and GDF‐15 had relatively high CVi (21.8% and 16.6%) and RCV (61.7% and 64.3%), whereas ST2 (CVi, 15.0; RCV, 42.9%), hsTnT (CVi, 11.1; RCV, 31.4%), and galectin‐3 (CVi, 8.1; RCV, 25.0%) had lower indices of variation. Biological variation indices are comparable between healthy subjects and HF patients for a broad spectrum of biomarkers. NT‐proBNP and GDF‐15 have substantial variation, with lower variation for ST2, hsTnT, and galectin‐3. These data are instrumental in proper interpretation of biomarker levels in HF patients.