[1]陈艺心a,潘 锋b,徐 娅b,等.β- 珠蛋白生成障碍性贫血患者血清FABP4，FGF19 水平表达及与预后的关系[J].现代检验医学杂志,2024,39(05):96-74.[doi:10.3969/j.issn.1671-7414.2024.05.018]
　CHEN Yixina,PAN Fengb,XU Yab,et al.Expression of Serum FABP4 and FGF19 Levels in Patients with β-Thalassemia and Their Relationship with Prognosis[J].Journal of Modern Laboratory Medicine,2024,39(05):96-74.[doi:10.3969/j.issn.1671-7414.2024.05.018]
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β- 珠蛋白生成障碍性贫血患者血清FABP4，FGF19 水平表达及与预后的关系()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年05期
页码:
96-74
栏目:
论著
出版日期:
2024-09-15

文章信息/Info

Title:
Expression of Serum FABP4 and FGF19 Levels in Patients with β-Thalassemia and Their Relationship with Prognosis
文章编号:
1671-7414（2024）05-096-06
作者:
陈艺心a; 潘 锋b; 徐 娅b; 彭 鑫b; 梁 露b; 李茹靖b; 李 聪b; 曾红鑫b
（重庆大学附属黔江医院 a. 输血科；b. 检验科，重庆 409000）
Author(s):
CHEN Yixina;  PAN Fengb;  XU Yab;  PENG Xinb;  LIANG Lub;  LI Rujingb;  LI Congb;  ZENG Hongxinb
（a.Department of Blood Transfusion；b.Department of Laboratory, Qianjiang Hospital Affiliated to Chongqing University, Chongqing 409000, China）
关键词:
β- 珠蛋白生成障碍性贫血; 脂肪酸结合蛋白4; 纤维细胞生长因子19
分类号:
R556.61；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.05.018
文献标志码:
A
摘要:
目的 研究β- 珠蛋白生成障碍性贫血（beta-thalassaemia，β-TM）患者血清脂肪酸结合蛋白4（fatty acidbindingprotein 4，FABP4）、纤维细胞生长因子19（fibroblast growth factor 19，FGF19）表达及其与预后的关系。方法 选取2018 年1 月～ 2020 年8 月重庆大学附属黔江医院诊治的112 例β- 珠蛋白生成障碍性贫血患者为病例组，选取同期体检的60 例健康人为对照组。采用酶联免疫吸附实验（ELISA）检测血清FABP4 和FGF19 水平。Logistic回归模型分析β- 珠蛋白生成障碍性贫血患者预后影响因素。受试者工作特征(ROC) 曲线分析血清FABP4 和FGF19对β- 珠蛋白生成障碍性贫血患者预后的预测价值。结果 病例组患者血清FABP4（67.13±11.35μg/L）水平高于对照组(22.01±4.16μg/L)，血清FGF19（104.24±21.46 ng/L）水平低于对照组(218.01±36.79 ng/L)，差异均具有统计学意义（t=29.708，25.620，均P ＜ 0.05）。轻型组、中间型组及重型组患者血清FABP4 水平（54.20±12.63μg/L,66.83±10.5μg/L，79.72±11.05μg/L） 依次升高， 而FGF19 水平（122.53±22.36 ng/L, 103.16±20.37 ng/L，86.53±18.14 ng/L）依次降低，差异具有统计学意义（F=39.701，24.231，均P ＜ 0.05）。相比于生存组，死亡组患者血清FGF19（62.80±22.09 ng/L vs 110.16±20.69 ng/L），血红蛋白、杂合子基因型比例（βCD17/βN，βCD41-42/βN）较低，而血清FABP4（116.69±12.30 ng/L vs 60.05±10.17 ng/L），铁蛋白及心脏增大比例较高，差异具有统计学意义（t/χ2=4.436 ～ 18.981，均P ＜ 0.05）。FGF19（OR=0.634，95％ CI：0.451 ～ 0.891）是β- 珠蛋白生成障碍性贫血患者预后的独立保护因素（P ＜ 0.001），血清FABP4（OR=1.840，95％ CI：1.193 ～ 2.838）为预后独立危险因素（P ＜ 0.001）。血清FABP4，FGF19 联合对β- 珠蛋白生成障碍性贫血患者预后评估的曲线下面积（95%CI）为0.897（0.853 ～ 0.951），大于单指标检测0.842（0.801 ～ 0.879）和0.814（0.762 ～ 0.858），差异具有统计学意义（Z=4.864，5.270，P=0.002，0.001）。结论 β- 珠蛋白生成障碍性贫血患者血清FABP4 升高，FGF19 降低。血清FABP4，FGF19 联合检测对β- 珠蛋白生成障碍性贫血患者预后具有较高的预测价值。
Abstract:
Objective To explore the expression of serum fatty acid-binding protein 4 (FABP4) and fibroblast growth factor 19 (FGF19) in patients with β-thalassemia and their relationship with clinical prognosis. Methods A total of 112 cases of β-thalassemia patients diagnosed and treated in Qianjiang Hospital Affiliated to Chongqing University from January 2018 to August 2020 were selected as the case group, and 60 healthy individuals who underwent physical examinations during the same period were taken as the control group. Enzyme-linked immunosorbent assay was used to detect levels of serum FABP4 and FGF19 expression. Multivariate logistic regression analysis was used to analyze factors affecting the prognosis of patients with β-thalassemia. Receiver operating characteristic curve was used to analyze the prognostic value of FABP4 and FGF19 in patients with β-thalassemia. Results The serum FABP4 level (67.13±11.35μg/L) in the case group was higher than that in the control group（22.01±4.16μg/L）, while the serum FGF19 level(104.24±21.46 ng/L ) was lower than that in the control group（218.01±36.79 ng/L）, with significant differences (t=29.708, 25.620，all P<0.05). The serum FABP4 levels (54.20±12.63μg/L, 66.83±10.5μg/L, 79.72±11.05μg/L) in the mild group, intermediate group, and severe group were increased sequentially, while FGF19 levels (122.53±22.36 ng/L, 103.16±20.37 ng/L, 86.53±18.14 ng/L) were decreased sequentially ，and the differences were significant (F=39.701, 24.231, all P<0.05). Compared to the survival group, serum FGF19 level (62.80±22.09 ng/L vs 110.16±20.69 ng/L), Hb and the proportion of heterozygous genotypes in the death group patients (βCD17/βN, βCD41-42/βN) was lower, while serum FABP4 (116.69±12.30 ng/L vs 60.05±10.17 ng/L), ferritin and the proportion of cardiac enlargement were higher, with significant differences (t/χ2=4.436 ～ 18.981, all P ＜ 0.05). FGF19 (OR=0.634，95%CI：0.451 ～ 0.891) was an independent protective factor for β-thalassemia patients（P ＜ 0.001）, and serum FABP4 (OR=1.840，95 ％ CI：1.193 ～ 2.838) was an independent risk factor for prognosis（P ＜ 0.001）. The area under the curve (95% CI) of serum FABP4 and FGF19 combination in prognosis evaluation for β-thalassemia patients was 0.897 (0.853 ～0.951), which was greater than the single serum indicator detection of 0.842 (0.801 ～0.879) and 0.814 (0.762 ～0.858), with significant differences (Z=4.864, 5.270, P=0.002, 0.001). Conclusion The serum FABP4 expression is increased, but serum FGF19 expression is decreased in patients with β-thalassemia. The combination of serum FABP4 and FGF19 may have a high predictive value for the prognosis of patients with β-thalassemia.

参考文献/References:

[1] KATTAMIS A, KWIATKOWSKI J L, AYDINOK Y. Thalassaemia[J]. Lancet, 2022, 399(10343): 2310-2324.
[2] ZHEN Xuemei, MING Jing, ZHANG Runqi, et al. Economic burden of adult patients with β-thalassaemia major in mainland China[J]. Orphanet Journal of Rare Diseases, 2023, 18(1): 252.
[3] MOTTA I, BOU-FAKHREDIN R, TAHER A T, et al. Beta thalassemia: new therapeutic options beyond transfusion and iron chelation[J]. Drugs, 2020, 80(11):1053-1063.
[4] 张璇, 赵爱琴, 邹丹, 等. 子宫内膜异位症患者血清miR-455 和FABP4 表达水平及临床意义[J]. 现代检验医学杂志, 2022, 37(4): 49-52, 158. ZHANG Xuan, ZHAO Aiqin, ZOU Dan, et al. Expression level and clinical significance of serum miR-455 and FABP4 in patients with endometriosis[J]. Journal of Modern Laboratory Medicine, 2022, 37(4): 49-52, 158.
[5] CRIPPA S, ROSSELLA V, APRILE A, et al. Bone marrow stromal cells from beta-thalassemia patients have impaired hematopoietic supportive capacity[J]. Journal of Clinical Investigation, 2019, 129(4): 1566-1580.
[6] FIANZA P I, RAHMAWATI A, AFIFAH S, et al. Correlation between serum fatty acid binding protein 4 (FABP4) levels and cardiac function in patients with thalassemia major[J]. Disease Markers, 2021, 2021: 5130628.
[7] XIE Meng, LIN Zhuoying, JI Xiaoyu, et al. FGF19/ FGFR4-mediated elevation of ETV4 facilitates hepatocellular carcinoma metastasis by upregulating PD-L1 and CCL2[J]. Journal of Hepatology, 2023, 79(1): 109-125.
[8] XIONG Hui, ZHANG Chunze, HAN Lifeng, et al. Suppressed farnesoid X receptor by iron overload in mice and humans potentiates iron-induced hepatotoxicity[J]. Hepatology, 2022, 76(2): 387-403.
[9] 张之南, 沈悌. 血液病诊断及疗效标准[M]. 3 版. 北京：科学出版社, 2007. ZHANG Zhinan, SHEN Ti. Diagnostic and therapeutic criteria for hematological diseases[M]. 3nd Ed. Beijing：Science Press, 2007.
[10] 洪炜聪, 方建培, 许吕宏. β- 地中海贫血基因治疗研究进展[J]. 中国实验血液学杂志, 2021, 29(5):1676-1679. HONG Weicong, FANG Jianpei, XU Lühong. Research progress on gene therapy for β-thalassemia-review[J]. Journal of Experimental Hematology, 2021, 29(5): 1676-1679.
[11] HARBI N S, JAWAD A H, ALSALMAN F K. Evaluation of adipokines concentration in iraqi patients with major and minor beta thalassemia[J]. Reports of Biochemistry & Molecular Biology, 2020, 9(2): 209-215.
[12] FURUHASHI M. Fatty acid-binding protein 4 in cardiovascular and metabolic diseases[J]. Journal of Atherosclerosis and Thrombosis, 2019, 26(3): 216-232.
[13] GONZALEZ F-FERRERO T, BERGONTI M, L?PEZCANOA J N, et al. Atrial fibrillation ablation in patients with arrhythmia-induced cardiomyopathy:a prospective multicentre study[J]. ESC Heart Failure, 2023, 10(5): 3055-3066.
[14] WANG Chaoping, HSU C C, HUNG W C, et al. Plasma fatty acid-binding protein 4 (FABP4) level is associated with abnormal QTc interval in patients with stable angina and chronic kidney disease[J]. BMC Cardiovascular Disorders, 2019, 19(1): 153.
[15] 胡雯勤, 潘琼妮, 李雪萍, 等. FGF19 亚家族在糖尿病及其微血管并发症发生发展中作用的研究进展[J]. 山东医药, 2021, 61(34): 91-94. HU Wenqin, PAN Qiongni, LI Xueping, et al. Research progress on the role of FGF19 subfamily in the occurrence and development of diabetes and its microvascular complications[J]. Shandong Medical Journal, 2021, 61(34): 91-94.
[16] WANG Longjiao, ZHAO Guoping, WANG Xifan, et al. Glycochenodeoxycholate affects iron homeostasis via Up-regulating hepcidin expression[J]. Nutrients, 2022, 14(15): 3176.
[17] ZHOU Jiyu, CUI Shuang, HE Qingxian, et al. SUMOylation inhibitors synergize with FXR agonists in combating liver fibrosis[J]. Nature Communications, 2020, 11(1): 240.
[18] WU Qing, SUN Lulu, HU Xiaomin, et al. Suppressing the intestinal farnesoid X receptor/sphingomyelin phosphodiesterase 3 axis decreases atherosclerosis[J]. Journal of Clinical Investigation, 2021, 131(9): 142865.
[19] BYUN S, KIM D H, RYERSON D, et al. Postprandial FGF19-induced phosphorylation by Src is critical for FXR function in bile acid homeostasis[J]. Nature Communications, 2018, 9(1): 2590.

相似文献/References:

[1]张 璇,赵爱琴,邹 丹,等.子宫内膜异位症患者血清miR-455 和FABP4 表达水平及临床意义[J].现代检验医学杂志,2022,37(04):49.[doi:10.3969/j.issn.1671-7414.2022.04.010]
　ZHANG Xuan,ZHAO Ai-qin,ZOU Dan,et al.Expression Level and Clinical Significance of Serum miR-455 and FABP4 in Patients with Endometriosis[J].Journal of Modern Laboratory Medicine,2022,37(05):49.[doi:10.3969/j.issn.1671-7414.2022.04.010]

备注/Memo

备注/Memo:
基金课题： 重庆市卫生健康委员会医学科研项目（2022WSJK016）；吉首大学指导性项目（Jdzd23026）。
作者简介：陈艺心（1988-），女，硕士研究生，副主任检验技师，研究方向：分子诊断、输血治疗，E-mail：chenyixin5346@126.com。
通讯作者：潘锋（1985-），男，硕士研究生，副主任技师，研究方向：临床免疫。
更新日期/Last Update: 2024-09-15