[1]朱 磊a,徐妍妍a,盛利平a,等.手足口病患儿血清FGF-21 与GDF-15 水平检测的临床诊疗应用研究[J].现代检验医学杂志,2023,38(05):180-184.[doi:10.3969/j.issn.1671-7414.2023.05.034]
　ZHU Leia,XU Yanyana,SHENG Lipinga,et al.Research on the Application of Serum FGF-21 and GDF-15 in Clinical Diagnosis and Treatment of Children with Hand, Foot and Mouth Disease[J].Journal of Modern Laboratory Medicine,2023,38(05):180-184.[doi:10.3969/j.issn.1671-7414.2023.05.034]
点击复制

手足口病患儿血清FGF-21 与GDF-15 水平检测的临床诊疗应用研究()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年05期
页码:
180-184
栏目:
检验与临床
出版日期:
2023-09-15

文章信息/Info

Title:
Research on the Application of Serum FGF-21 and GDF-15 in Clinical Diagnosis and Treatment of Children with Hand, Foot and Mouth Disease
文章编号:
1671-7414（2023）05-180-05
作者:
朱 磊a; 徐妍妍a; 盛利平a; 温娜娜a; 胡爽爽a; 钱 同b
（徐州医科大学附属徐州儿童医院 a. 重症医学科；b. 检验科，江苏徐州 221006）
Author(s):
ZHU Leia;  XU Yanyana;  SHENG Lipinga;  WEN Nanaa;  HU Shuangshaunga;  QIAN Tongb
（a.Department of Intensive Care Unit；b.Department of Clinical Laboratory, Xuzhou Children’s Hospital of Xuzhou Medical University，Jiangsu Xuzhou 221006，China）
关键词:
成纤维细胞生长因子21; 生长分化因子15; 手足口病
分类号:
R512.5；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.05.034
文献标志码:
A
摘要:
目的 探讨手足口病（hand, foot and mouth disease，HFMD）患儿血清成纤维细胞生长因子21（fibroblastgrowth factor 21，FGF-21）和生长分化因子15（growth differentiation factor 15，GDF-15）表达水平及临床价值。方法 选取2018 年5 月～ 2022 年5 月徐州医科大学附属徐州儿童医院诊治的HFMD 患儿80 例为研究对象，分为普通型组和重症组，每组40 例；以同期因腹股沟斜疝诊治且无基础疾病的30 例患儿作为对照组。应用酶联免疫吸附试验（enzyme linked immunosorbent assay，ELISA） 检测血清FGF-21 和GDF-15 水平。受试者工作特征（ROC）曲线分析两指标单独及联合检测对重症HFMD 的诊断价值。结果 重症组血清FGF-21，GDF-15，IL-6 水平分别为101.96±25.15 pg/ml，702.95±123.38pg/ml 和176.73±74.01pg/ml，高于普通型组（84.10±18.85pg/ml，515.78±115.96pg/ml，105.80±35.33pg/ml）和对照组（77.51±17.12 pg/ml，337.33±121.07pg/ml，81.43±16.53pg/ml），差异均有统计学意义（t=3.595，6.991，5.469；4.585，12.368，7.855，均P ＜ 0.001）。与对照组相比，普通型组血清GDF-15 水平升高，差异有统计学意义（t=6.252，P ＜ 0.001）。治疗7 天后，重症组和普通型组血清FGF-21，GDF-15 水和IL-6平均低于治疗前，差异均有统计学意义（t=5.599，6.741，6.537；2.741，6.711，7.266，均P ＜ 0.05）。ROC 分析显示，血清FGF-21，GDF-15 诊断重症HFMD 的曲线下面积（AUC）分别为0.723（95%CI：0.611 ～ 0.835），0.868（95%CI：0.792 ～ 0.944），敏感度分别为92.50%，87.50%，特异度分别为52.50%，72.50%；两者联合串联检测诊断重症HFMD的AUC 为0.875（95%CI：0.791 ～ 0.959），其敏感度和特异度分别为80.00%，82.50%。结论 重症HFMD 患儿血清FGF-21，GDF-15 水平升高，检测其表达水平对重症HFMD 的诊断具有重要参考价值。
Abstract:
Objective To investigate the serum levels of fibroblast growth factor 21 (FGF-21) and growth differentiation factor 15 (GDF-15) in children with hand, foot and mouth disease (HFMD) and their clinical significance. Methods 80 children with HFMD diagnosed and treated in Xuzhou Children’s Hospital of Xuzhou Medical University from May 2018 to May 2022 were selected and classified into severe group and common group, with 40 cases in each group.30 children with oblique inguinal hernia but no underlying disease during the same period were selected as control group. Serum FGF-21 and GDF-15 levels in each group were detected by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of serum FGF-21, GDF-15 and combined detection for severe HFMD. Results Serum FGF-21, GDF-15 and IL-6 levels in the severe HFMD group were 101.96±25.15 pg/ml，702.95±123.38pg/ml and 176.73 ±74.01pg/ ml, respectively，higher than those in common group（84.10±18.85pg/ml，515.78±115.96 pg/ml, 105.80±35.33pg/ml） and control group（77.51±17.12 pg/ml，337.33±121.07pg/ml, 81.43±16.53pg/ml），and the differences were statistically significant (t=3.595, 6.991, 5.469; 4.585, 12.368, 7.855, all P ＜ 0.001). Compared with the control group，the serum GDF-15 level in the common group was increased，and the difference was statistically significant（t=6.252，P ＜ 0.001）. After 7 days of treatment, serum FGF-21, GDF-15 and IL-6 in severe and common groups were decreased, and the differences were statistically significant (t= 5.599, 6.741, 6.537; 2.741, 6.711, 7.266, all P< 0.05). The ROC curve showed that the area under the curve (AUC) of serum FGF-21 and GDF-15 levels predicting severe HFMD were 0.723（95%CI：0.611 ～ 0.835）and 0.868 （95%CI：0.792 ～ 0.944）, sensitivity was 92.50%, 87.50%, specificity was 52.50%, 72.50%, respectively. The AUC of the two combined prediction in series of severe HFMD was 0.875（95%CI：0.791 ～ 0.959）, and the sensitivity and specificity were 80.00% and 82.50%, respectively. Conclusion The levels of serum FGF-21 and GDF-15 in children with severe HFMD were significantly increased, and has important reference value for the diagnosis of severe HFMD.

参考文献/References:

[1] LI Xingwang, NI Xin, QIAN Suyun, et al. Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition)[J]. World Journal of Pediatrics, 2018, 14(5): 437-447.
[2] YANG Yang, CONG Haolong, DU Ning, et al. Mitochondria redistribution in enterovirus A71 infected cells and its effect on virus replication[J]. Virologica Sinica, 2019, 34(4): 397-411.
[3] YANG Xiaoxia, SHUI Xiaochuan, DAI Xiaoqing, et al. PLAC8 promotes EV71 infected inflammatory lesion by disturbing Th-cell-related cytokines release in neonatal mouse [J]. Virology,2021,564:39-45.
[4] LI Yi, LI Shengrui, QIU Yinfeng, et al. Circulating FGF21 and GDF15 as biomarkers for screening, diagnosis, and severity assessment of primary mitochondrial disorders in children[J]. Front Pediatr,2022,10:851534.
[5] LEHTONEN J M, AURANEN M, DARIN N, et al. Diagnostic value of serum biomarkers FGF21 and GDF15 compared to muscle sample in mitochondrial disease [J]. Journal of Inherited Metabolic Disease, 2021, 44(2): 469-480.
[6] KAUR N, GARE S R, RUIZ-VELASCO A, et al. FGF21/FGFR1-β-KL cascade in cardiomyocytes modulates angiogenesis and inflammation under metabolic stress[J]. Heliyon, 2023, 9(4): e14952.
[7] KATO E T, MORROW D A, GUO Jianping, et al. Growth differentiation factor 15 and cardiovascular risk:individual patient meta-analysis[J]. European Heart Journal, 2023, 44(4): 293-300.
[8] 李玄丹, 李材忠, 唐永婕, 等．老年ARDS 患者血清FGF-21,GDF-15 及PTX-3 表达水平及其与病情评估和预后的相关性研究[J]. 现代检验医学杂志, 2022,37(4): 188-192. LI Xuandan, LI Caizhong, TANG Yongjie, et al. Expression levels of serum FGF-21, GDF-15 and PTX-3 in elderly patients with ARDS and their correlation with disease evaluation and prognosis [J]. Journal of Modern Laboratory Medicine, 2022, 37(4): 188-192.
[9] YIN Dan, YAN Xiaofang, BAI Xueke, et al. Prognostic value of growth differentiation factors 15 in acute heart failure patients with preserved ejection fraction[J]. ESC Heart Failure, 2023, 10(2): 1025-1034.
[10] DAVIS R L, LIANG C, SUE C M. A comparison of current serum biomarkers as diagnostic indicators of mitochondrial diseases[J]. Neurology, 2016, 86(21): 2010-2015.
[11] RILEY L G, NAFISINIA M, MENEZES M J, et al. FGF21 outperforms GDF15 as a diagnostic biomarker of mitochondrial disease in children[J]. Molecular Genetics and Metabolism, 2022, 135(1): 63-71.
[12] KANG Kai, XU Pengfei, WANG Mengxia, et al. FGF21 attenuates neurodegeneration through modulating neuroinflammation and oxidant-stress [J].Biomed Pharmacother, 2020,129:110439.
[13] LENG Yan, WANG Junyu, WANG Zhifei, et al. Valproic acid and other HDAC inhibitors upregulate fgf21 gene expression and promote process elongation in glia by inhibiting HDAC2 and 3 [J]. Int J Neuropsychoph, 2016,19(8): pyw035.
[14] LUAN H H, WANG A, HILLIARD B K, et al. GDF15 is an Inflammation-Induced central mediator of tissue tolerance[J]. Cell, 2019, 178(5): 1231-1244.e11.
[15] R?HLE A, WIEDENMANN N, FENNELL J T, et al. Interleukin-6 as surrogate marker for imaging-based hypoxia dynamics in patients with head-and-neck cancers undergoing definitive chemoradiation-results from a prospective pilot trial[J]. European Journal of Nuclear Medicine and Molecular Imaging, 2022, 49(5): 1650-1660.
[16] 王秋云, 严敏, 程珍, 等．肿瘤及血液病患者血清sTRAIL 表达及与IL-6 和Hepcidin 水平的相关性研究[J]. 现代检验医学杂志, 2021, 36(1): 58-60, 64. WANG Qiuyun, YAN Min, CHENG Zhen, et al.Study of the expression of the serum sTRAIL, and its correlation with levels of serum IL-6 and hepcidin in the patients with the tumor and hematological diseases[J]. Journal of Modern Laboratory Medicine, 2021, 36(1): 58-60, 64.
[17] ZHU Lei, YIN Hong, QIAN Tong, et al. Distinct expression and clinical value of aquaporin 4 in children with hand, foot and mouth disease caused by enterovirus 71[J]. Journal of Medical Virology, 2022, 94(2): 587-593.
[18] LEE J Y, SON M, KANG Jinhan, et al. Serum interleukin-6 levels as an indicator of aseptic meningitis among children with enterovirus 71-induced hand, foot and mouth disease[J]. Postgraduate Medicine, 2018, 130(2): 258-263.
[19] TAVENIER J, RASMUSSEN L J H, ANDERSEN A L, et al. Association of GDF15 with inflammation and physical function during aging and recovery after acute hospitalization: a longitudinal study of older patients and Age-Matched controls[J]. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 2021, 76(6): 964-974.
[20] YANG Pinni, ZHU Zhengbao, SHI Mengyao, et al. Association of serum growth differentiation factor-15 levels with the risks of death and vascular events in patients with ischemic stroke: The role of diabetes[J].Nutrition Metabolism and Cardiovascular Diseases, 2022, 32(3): 616-623.
[21] WANG Bei, ZHANG Chongyang, YU Congci, et al. Enterovirus 71 induces INF2 cleavage via activated caspase-2 in infected RD cells [J]. Front Microbiol,2021,12:684953.

相似文献/References:

[1]范 雪a,秦文沛b,唐钰姣a,等.代谢综合征患者血清25 (OH)D和GDF 15水平表达与并发甲状腺结节发生恶性风险的相关性研究[J].现代检验医学杂志,2024,39(06):147.[doi:10.3969/j.issn.1671-7414.2024.06.025]
　FAN Xuea,QIN Wenpeib,TANG Yujiaoa,et al.Study on the Correlation between the Expression of Serum 25(OH)D and GDF15 Levels and the Risk of Malignancy in Combined Thyroid Nodules in Patients with Metabolic Syndrome[J].Journal of Modern Laboratory Medicine,2024,39(05):147.[doi:10.3969/j.issn.1671-7414.2024.06.025]
[2]李玄丹,李材忠,唐永婕,等.老年ARDS 患者血清FGF-21，GDF-15 及PTX-3 表达水平及其与病情评估和预后的相关性研究[J].现代检验医学杂志,2022,37(04):188.[doi:10.3969/j.issn.1671-7414.2022.04.037]
　LI Xuan-dan,LI Cai-zhong,TANG Yong-jie,et al.Expression Levels of Serum FGF-21, GDF-15 and PTX-3 in Elderly Patients with ARDS and Their Correlation with Disease Evaluation and Prognosis[J].Journal of Modern Laboratory Medicine,2022,37(05):188.[doi:10.3969/j.issn.1671-7414.2022.04.037]

备注/Memo

备注/Memo:
基金项目： 徐州市卫生健康委科技项目（XWKYHT20200006）：BNIP3 介导的自噬通路在重症手足口病脑损伤中作用的临床研究；彭城英才- 医学青年后备人才项目（XWRCHT20220021）：BNIP3 介导的线粒体自噬在创伤性脑损伤中的作用及机制研究。
作者简介：朱磊（1985-），男，硕士，副主任医师，副教授，研究方向：儿科感染性疾病，E-mail：xuzhouzhulei317@163.com。
通讯作者：钱同（1980-），男，硕士，副主任技师，研究方向：临床检验，E-mail：124183077@qq.com。
更新日期/Last Update: 2023-09-15