血清FGF21和SIRT3水平对慢性心力衰竭患者病情及预后评估的价值

Value of serum FGF21 and SIRT3 levels in assessing the condition and prognosis of patients with chronic heart failure

目的:对慢性心力衰竭(congestive heartfailure,CHF)患者的病情及预后进行早期评估有助于降低其病死率,改善其预后。本研究旨在探索CHF患者血清成纤维细胞生长因子21(fibroblast growth factor 21,FGF21)和沉默信息调节因子2相关酶3(silent information regulator factor 2 related enzyme 3,SIRT3)水平及其在患者病情及预后评估中的应用价值。方法:选取2021年1月至2022年6月确诊的164例CHF患者作为疾病组,选择同期160例健康体检者作为对照组。采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测血清FGF21和SIRT3水平,采用多普勒超声仪检测患者左室重量指数(left ventricular weight index,LVMI)、左心室舒张期末内径(left ventricular end-diastolic internal diameter,LVEDD)、左房内径(left atrium diameter,LAD)、左室射血分数(left ventricular ejection fractions,LVEF);Pearson相关性分析血清FGF21、SIRT3分别与LVMI、LVEDD、LAD的相关性;采用受试者操作特征(receiver operator characteristic,ROC)曲线分析血清FGF21和SIRT3对CHF患者预后的诊断价值,采用Kaplan-Meier法分析FGF21和SIRT3与CHF患者预后的关系。结果:与对照组比较,疾病组LVMI、LVEDD、LAD及FGF21水平均升高,SIRT3水平降低(均P<0.05);不同心功能分级患者血清FGF21和SIRT3水平差异均有统计学意义(均P<0.05);FGF21水平与LVMI、LVEDD、LAD呈正相关,SIRT3水平与LVMI、LVEDD、LAD和FGF21水平呈负相关(均P<0.05);FGF21和SIRT3联合诊断CHF患者预后的曲线下面积(area under the curve,AUC)显著大于FGF21单独诊断的AUC(Z=2.645,P=0.008)及SIRT3单独诊断的AUC(Z=2.738,P=0.006),FGF21高表达组生存率低于低表达组(χ^(2)=8.257,P=0.004),SIRT3高表达组生存率高于低表达组(χ^(2)=15.305,P<0.001)。结论:CHF患者血清FGF21水平升高,SIRT3水平降低,FGF21与SIRT3联合在CHF病情及预后评估中具有较高的应用价值。

Objective:Early assessment of the condition and prognosis of patients with chronic heart failure(CHF)helps reduce mortality and improve prognosis.This study aims to explore the levels of serum fibroblast growth factor 21(FGF21)and silent information regulator factor 2 related enzyme 3(SIRT3)in CHF patients and their value in assessing the patients’condition and prognosis.Methods:A total of 164 patients diagnosed with CHF from January 2021 to June 2022 were selected as the disease group,and 160 healthy individuals were selected as the control group.Serum FGF21 and SIRT3 levels were detected using enzyme-linked immunosorbent assay(ELISA).The left ventricular weight index(LVMI),left ventricular end-diastolic internal diameter(LVEDD),left atrium internal diameter(LAD),and left ventricular ejection fraction(LVEF)were measured using a Doppler ultrasound device.Pearson correlation analysis was used to assess the correlations between serum FGF21,SIRT3,and LVMI,LVEDD,and LAD.The diagnostic value of serum FGF21,and SIRT3 for CHF prognosis was analyzed using receiver operator characteristic(ROC)curves.The relationship between FGF21 and SIRT3 and CHF prognosis was analyzed by the Kaplan-Meier method.Results:Compared to the control group,the disease group had higher levels of LVMI,LVEDD,LAD,and FGF21,and lower levels of SIRT3(all P<0.05).There were statistically significant differences in serum FGF21 and SIRT3 levels among patients with different cardiac function grades(P<0.05).FGF21 levels were positively correlated with LVMI,LVEDD,and LAD,while SIRT3 levels were negatively correlated with LVMI,LVEDD,LAD,and FGF21 levels(all P<0.05).The area under the curve(AUC)for the combined diagnosis of CHF prognosis using FGF21 and SIRT3 was significantly greater than the AUC for FGF21 alone(Z=2.645,P=0.008)and SIRT3 alone(Z=2.738,P=0.006).The survival rate in the high FGF21 expression group was lower than in the low expression group(χ^(2)=8.257,P=0.004),and the survival rate in the high SIRT3 expression group was higher than in the low expression group(χ^(2)=15.305,P<0.001).Conclusion:Serum FGF21 levels are elevated and SIRT3 levels are decreased in CHF patients.The combination of FGF21 and SIRT3 has high application value in assessing the condition and prognosis of CHF patients.