Biomarkers in medicine最新文献

Aim: To explore the relationship between plasma myeloperoxidase (MPO) and glaucoma, assessing the clinical utility of MPO in glaucoma.

Methods: A cross-sectional study involved 127 glaucoma patients and 106 healthy controls. Plasma MPO markers were quantified using enzyme-linked immunosorbent assay (ELISA), comparing levels between glaucoma patients and healthy controls, and analyzing plasma MPO across different glaucoma severity grades.

Results: In this study, we observed elevated plasma MPO levels in glaucoma patients (p < 0.001). After correcting for confounders such as age, sex, hypertension, and diabetes, plasma MPO remained independently associated with glaucoma (OR = 1.05, 95% CI: 1.04-1.07, p < 0.001). Plasma MPO may reflect the severity of glaucoma, with significant differences in plasma MPO observed between early and severe stages, but not in the moderate stages. In addition, elevated plasma MPO was associated with higher cup-to-disc ratios. ROC curve analysis demonstrated the validity of glaucoma markers in identifying early glaucoma from severe glaucoma (early versus severe: AUC = 0.633).

Conclusion: Elevated plasma MPO levels are independently associated with glaucoma risk, suggesting it might provide insight into disease pathogenesis.

Background: Corin is a cardiac protease that plays a role in transforming pro-natriuretic peptides into their active biological forms. This study aimed to investigate the relationship between serum corin levels and functional capacity in patients with advanced heart failure.

Methods: This cross-sectional study included 88 consecutive patients with LVEF (Left ventricular ejection fraction) <25% who were referred to the tertiary cardiovascular center. Serum corin levels were measured using ELISA (Enzyme-linked immunosorbent assay) prior to CPET (Cardiopulmonary exercise testing). Multivariable linear regression was used to assess the independent association between serum corin levels and peak VO₂ (Peak oxygen consumption).

Results: The mean age was 51.3 ± 12.2 years, and 86.4% were male. The mean peak VO₂ was 13.6 ± 3.99 mL/min/kg and the mean serum corin level was 1.7 ± 0.82 ng/mL. In multivariable analysis, serum corin level was an independent predictor of peak VO₂ (Coefficient: 1.206, 95% CI: 0.527-1.880, p = 0.0007).

Conclusion: Lower serum corin levels are independently associated with reduced functional capacity in advanced heart failure. Corin may serve as a valuable biomarker to complement CPET in clinical evaluation, risk stratification, and treatment planning.

Introduction: MicroRNA (miRNA) single nucleotide polymorphisms (miRNA-SNPs) have been associated with pediatric acute lymphoblastic leukemia (ALL). However, since the results of these individual studies have been inconsistent, we performed a meta-analysis to help establish a statistical significance for the association between miRNA-SNPs and pediatric ALL risk. We also analyzed whether they confer susceptibility across country-specific studies by using different genetic models.

Methods: Articles published from 2001 to 2023 were collected from PubMed and Google Scholar databases. Through MetaGenyo, the association between miRNA- SNPs and pediatric ALL risk was calculated by pooled odds ratio [ORs] and 95% CI. A subgroup analysis of pooled ORs in country-specific studies was also performed.

Results: Based on the inclusion and exclusion criteria, 14 studies were analyzed to extract data on miR146 rs2910164, miR-196a2 rs11614913, miR-612 rs12803915 and mir-499 rs3746444. While the pooled data analysis did not reveal any association, a subgroup analysis demonstrated country-specific differences in allele frequencies of all the four miRNAs in various genetic models, implying ethnicity-based risk.

Conclusion: Our results suggested that miRNA-SNPS can still be considered as a potential risk factor to be explored in more populations.

Objective: This retrospective study evaluated the predictive power of a new marker for pre-eclampsia (PE), the neutrophil percentage/albumin ratio (NPAR).

Methods: A total of 399 participants consisting of 133 pregnant women diagnosed with PE and 266 healthy pregnant controls were included in the study. Data collected included demographic and obstetric history, gestational age at diagnosis, maternal hematological and biochemical parameters, first trimester neutrophil/albumin ratio (NAR) and NPAR values, and neonatal outcomes.

Results: The pre-eclampsia group showed significantly higher NAR (mean: 312.30, range: 80.00-1568.00) and NPAR (mean: 3.14 ± 0.81) compared to the control group (mean NAR: 234.40, range: 78.16-725.00; mean NPAR: 2.06 ± 0.38; p = 0.001 for both). Furthermore, early-onset PE was associated with significantly higher NAR (395.00 vs. 256.23, p = 0.001) and NPAR (3.87 vs. 2.80, p = 0.001) compared to late-onset PE. For early-onset PE, NPAR showed a sensitivity of 76.19%, specificity of 92.31%, PPV of 82.05%, NPV of 89.36% and area under the curve (AUC) of 0.897, demonstrating its strong potential as an early predictor of pre-eclampsia.

Conclusion: NPAR is elevated in PE compared to healthy pregnancies, demonstrating its potential as a simple yet effective biomarker for predicting PE.

Background: This study assesses the influence of early hyperlactatemia after the transcatheter aortic valve implantation (TAVI) procedure on subsequent outcomes.

Methods: Adult patients undergoing elective percutaneous TAVI between 2012 and 2022 in a single tertiary cardiac center were retrospectively included. Peak post-procedure lactate level within 24-h was recorded for 284 patients included in the study. The primary outcome measured was 30-day mortality.

Results: 19 patients (6.6%) experienced 30-day mortality. Patients with mortality were characterized by advanced age (p = 0.022) and higher lactate levels after the procedure (5.4 ± 5.4 mmol/L vs 1.3 ± 0.6 mmol/L, p < 0.001). Post-procedure hyperlactatemia was an independent predictor of mortality (OR 3.95, 95% CI 1.35-11.60, p = 0.012). ROC analysis revealed 1.54 mmol/L as a cutoff for mortality with 85.7% specificity and 68.4% sensitivity.

Conclusion: The initial 24-hour lactate levels seem to play a valuable role in predicting the likelihood of surviving during the hospital stay after the implantation procedure. Further investigation is required to ascertain the optimal strategies for managing early post-procedure hyperlactatemia in the TAVI population.

Background: Type 2 CRS is characterized by the development of renal dysfunction secondary to chronic cardiac disease. Despite its high morbidity and mortality, there is a lack of robust diagnostic tools and prognostic models to guide clinical management.

Methods: This multicenter retrospective study included patients diagnosed with CRS type 2 based on the 2019 American Heart Association definition. Data were collected from electronic medical records of three hospitals between January 2021 and December 2023. Advanced statistical methods, including receiver operating characteristic (ROC) curve analysis, univariate Kaplan-Meier (KM) analysis, and multivariable Cox proportional hazards regression, were utilized to develop a nomogram for predicting patient prognosis.

Results: The study included 519 patients with CRS-2. Independent predictors of adverse outcomes included elevated serum creatinine and blood urea nitrogen (BUN) levels, decreased platelet count, elevated B-type natriuretic peptide (BNP), and decreased oxygen partial pressure (PaO2). These findings suggest that close monitoring of these markers is essential in clinical practice to identify patients at high risk of adverse events early on.

Conclusion: Our study provides evidence that serum creatinine, BUN, platelet count, BNP, and PaO2 are independent predictors of adverse outcomes in patients with Type 2 CRS.

Background: This study assessed serum GP73, Nrf2, and CHE levels in pregnancy-associated liver injury and explored their nonlinear risk relationships using restricted cubic spline (RCS) models to establish diagnostic thresholds for early screening.

Methods: Conducted from December 2022 to December 2024, 105 pregnant women with liver injury (research group) and 187 healthy controls were retrospectively analyzed. Multivariate logistic regression, ROC curves, RCS models, and decision curve analysis (DCA) evaluated associations, predictive efficacy, dose-response relationships, and clinical utility of these biomarkers.

Results: Elevated GP73 and Nrf2, multiple pregnancies, antipyretic/anti-infective medication use, and malnutrition were risk factors (p < 0.05), while high CHE was protective (p < 0.05). ROC analysis showed AUCs of 0.801 (GP73), 0.785 (Nrf2), and 0.726 (CHE) combined AUC reached 0.951. RCS revealed nonlinear dose-response relationships (p < 0.001), and DCA confirmed clinical significance (net benefit > 0) for individual and combined biomarkers, with the panel showing the highest utility.

Conclusion: GP73, Nrf2, and CHE demonstrated nonlinear associations with pregnancy-related liver injury, particularly GP73. Combined measurement enhances clinical value for early prediction.

Introduction: We investigated the potential correlation between abnormal blood glucose on admission and clinical outcomes of acute calculus cholecystitis in older patients.

Areas covered: We included older patients (≥65 years) diagnosed with acute calculus cholecystitis. The first plasma glucose measurement obtained at admission was used. Overall, 280 older patients were evaluated. The results showed that ABG was significantly associated with more severe systemic inflammatory responses (elevated white blood cell count and neutrophil-lymphocyte ratio), a higher incidence of moderate to severe ACC, and the need for invasive treatment (an increased proportion of percutaneous cholecystostomy and combined surgeries). The prolonged hospital stay, 30-day readmission rate and mortality rate of patients in the ABG group were significantly increased, and the incidence of severe postoperative complications (Clavien-Dindo≥grade III) was higher. Multivariate analysis confirmed that ABG was an independent predictor of the severity of ACC (TG18 classification) and 30-day re-admission rate.

Expert opinion/commentary: In older patients with acute calculus cholecystitis, abnormal blood glucose on admission is associated with worse outcomes, serving as a novel quantifiable risk criterion to guide treatment selection, particularly for high-risk older adults ineligible for early surgery.