Correlation of serum sST2 and liver function, platelet level and Ishak score in chronic hepatitis B patients

doi:10.3969/j.issn.1004-583X.2021.11.003

Abstract

Abstract:

Objective To observe the expression of serum soluble suppression of tumorigenicity-2 (sST2) in patients with chronic hepatitis B (CHB), and to analyze the correlation of sST2 and liver function, platelet(PLT) and Ishak score. Methods Totally 190 inpatients with CHB who met the inclusion criteria were prospectively enrolled from December 2018 to December 2020 in Dalian Sixth People's Hospital. The patients were divided into no fibrosis (29 cases), fibrosis (124 cases), and cirrhosis (37 cases) according to Ishak inflammation score. Thirty healthy controls in the physical examination center during the same period were recruited. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin (ALB), total bilirubin (TBIL), sST2 and PLT were detected, and APRI was counted. Results There were significant differences in serum sST2, AST, ALT, ALB, TBIL, APRI and PLT among four groups (P<0.05). Compared with controls, sST2, AST, ALT and TBIL in CHD patients were significantly higher (P<0.05), while serum ALB was significantly lower (P<0.05). Compared with patients with and without fibrosis, serum sST2, AST, ALT and TBIL of cirrhosis patients were significantly higher (P<0.05), while ALB and PLT were significantly lower (P<0.05). Compared with controls, PLT of cirrhosis patients was significantly lower (P<0.05). Pearson results showed that sST2 of CHB patients was closely related to AST, ALT, ALB, TBIL, PLT and APRI (r=0.939, 0.918, -0.816, 0.795, -0.469, 0.933, P<0.05). Spearman results showed that there was positive correlation between serum sST2 and Ishak score (r=0.885, P<0.05). Multivariate analysis showed that AST, ALT, ALB, TBIL, PLT, and Ishak score were influencing factors for sST2. The AUC values of the area under ROC curve of SST2, APRI and the combined diagnosis of cirrhosis were 0.715, 0.789 and 0.806. The sensitivity were 0.700, 0.780 and 0.810. The specificity 0.903, 0.847, 0.855, respectively. Conclusion For CHB patients, when serum sST2 abnormally elevates, liver fibrosis increases. At the same time, influencing factors for serum sST2 are liver function indexes. PLT and Ishak score, and serum sST2 combined with APRI can improve the predictive value of cirrhosis.

Key words: hepatitis B,chronic, hepatic insufficiency, inflammation, blood platelets, liver fibrosis

CLC Number:

R512.62

Wang Yuanyuan, Cheng Ning, Lin Haiyan. Correlation of serum sST2 and liver function, platelet level and Ishak score in chronic hepatitis B patients[J]. Clinical Focus, 2021, 36(11): 976-980.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.11.003

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I11/976

Figures/Tables 12

组别	例数	性别[例(%)]		年龄 ( $x -$ ±s,岁)	病程 ( $x -$ ±s,年)	合并病[例(%)]
组别	例数	男	女	年龄 ( $x -$ ±s,岁)	病程 ( $x -$ ±s,年)	糖尿病	高血压
无纤维化	29	17(58.62)	12(41.38)	43.31±6.85	5.21±2.01	6(20.69)	3(10.34)
纤维化	124	72(58.06)	52(41.94)	44.13±6.72	5.19±2.00	13(10.48)	12(9.68)
肝硬化	37	27(72.97)	10(27.03)	43.57±6.81	5.14±2.03	7(18.92)	5(13.51)
对照组	30	18(60.00)	12(40.00)	44.83±6.71	-	-	-
χ²/F值		0.038		0.318	0.014	2.251	0.012
P值		0.846		0.812	0.986	0.134	0.913

组别	例数	性别[例(%)]		年龄 ( $x -$ ±s,岁)	病程 ( $x -$ ±s,年)	合并病[例(%)]
组别	例数	男	女	年龄 ( $x -$ ±s,岁)	病程 ( $x -$ ±s,年)	糖尿病	高血压
无纤维化	29	17(58.62)	12(41.38)	43.31±6.85	5.21±2.01	6(20.69)	3(10.34)
纤维化	124	72(58.06)	52(41.94)	44.13±6.72	5.19±2.00	13(10.48)	12(9.68)
肝硬化	37	27(72.97)	10(27.03)	43.57±6.81	5.14±2.03	7(18.92)	5(13.51)
对照组	30	18(60.00)	12(40.00)	44.83±6.71	-	-	-
χ²/F值		0.038		0.318	0.014	2.251	0.012
P值		0.846		0.812	0.986	0.134	0.913

组别	例数	sST2 (ng/ml)	AST (U/L)	ALT (U/L)	ALB (g/L)	TBIL (μmol/L)	PLT (×10⁹/L)	APRI
无纤维化	29	11.97±3.50^*	41.30±11.29^*	38.60±9.08^*	33.25±8.36^*	23.87±6.38^*	187.31±40.18	0.61±0.29^*
纤维化	124	19.28±5.10^*△	87.29±16.62^*△	79.42±14.53^*△	26.22±7.38^*△	49.62±13.41^*△	172.58±36.23^*	1.37±0.55^*△
肝硬化	37	37.61±9.32^*△#	189.77±32.22^*△#	177.87±29.02^*△#	16.31±5.54^*△#	78.11±14.37^*△#	148.79±34.32^*△#	3.49±1.40^*△#
对照组	30	6.23±1.11	21.57±6.49	18.11±4.19	36.55±9.11	19.99±5.29	198.31±43.26	0.29±0.13
F值		204.724	546.974	630.987	48.343	169.263	11.069	139.557
P值		0.000	0.000	0.000	0.000	0.000	0.000	0.000

变量	回归系数	标准误	t值	P值	OR值	95%CI
变量	回归系数	标准误	t值	P值	OR值	下限	上限
AST	0.184	0.025	7.247	0.000	0.928	0.134	0.235
ALT	0.168	0.011	15.124	0.000	0.792	0.146	0.190
ALB	-0.139	0.047	-2.937	0.004	-0.121	-0.232	-0.046
TBIL	0.394	0.022	17.976	0.000	0.795	0.351	0.437
PLT	-0.049	0.008	-6.131	0.000	-0.184	-0.065	-0.033
APRI	7.827	0.220	35.772	0.000	0.933	7.424	8.290
Ishak评分	0.165	0.010	16.314	0.000	0.778	0.145	0.185

变量	截断值	AUC	P值	敏感度	特异度	95%CI
变量	截断值	AUC	P值	敏感度	特异度	下限	上限
sST2	26.755 ng/ml	0.715	0.000	0.700	0.903	0.594	0.837
APRI	1.925	0.789	0.000	0.780	0.847	0.68	0.898
联合	8.965	0.806	0.000	0.810	0.855	0.704	0.907

References 15

[1]	Lampertico P, Colombo M. Nucleos(t)ide analog therapy of chronic hepatitis B and liver cancer risk reduction: Better nucleotides than nucleosides?[J]. Gastroenterology, 2019, 157(6):1682-1684. doi: S0016-5085(19)41448-0 pmid: 31622619
[2]	Kim BK. Reply to: “Comment on-A multi-center study of entecavir vs. tenofovir on prognosis of treatment-naïve chronic hepatitis B in the Republic of Korea”[J]. J Hepatol, 2020, 72(1):198-199. doi: 10.1016/j.jhep.2019.10.012 URL
[3]	李劲, 骆仲榆, 陈刘镇, 等. 慢性乙型肝炎病毒感染患者血清IL-33、sST2、MCP-1水平变化及其临床意义[J]. 中国医药导报, 2019, 16(17):125-128.
[4]	Yuan W, Mei X, Zhang YY, et al. High expression of interleukin-33/ST2 predicts the orogression and poor prognosis in chronic hepatitis B patients with hepatic flare[J]. Am J Med Sci, 2020, 360(6):656-661. doi: 10.1016/j.amjms.2020.06.023 pmid: 32988596
[5]	王贵强, 王福生, 成军, 等. 慢性乙型肝炎防治指南(2015年版)[J]. 中华实验和临床感染病杂志(电子版), 2015, 19(5):1-18.
[6]	Ishak K, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis[J]. J Hepatol, 1995, 22(6):696-699. pmid: 7560864
[7]	江萍, 王存凯, 王玉珍. 血清学指标评估乙型肝炎肝纤维化程度及预后的研究进展[J]. 临床荟萃, 2020, 35(10):947-951.
[8]	Cardellini M, Rizza S, Casagrande V, et al. Soluble ST2 is a biomarker for cardiovascular mortality related to abnormal glucose metabolism in high-risk subjects[J]. Acta Diabetologica, 2019, 56(3):273-280. doi: 10.1007/s00592-018-1230-z pmid: 30259114
[9]	Figal DAP, Genis AB, Lopez A, et al. The interleukin-1 axis and risk of death in patients with acutely decompensated heart failure[J]. J Am Coll Cardiol, 2019, 73(9):1016-1025.
[10]	陈泽江, 黄修献, 曾敏, 等. 血浆sST2, cTnⅠ, hs-CRP, NT-proBNP水平对急性心肌梗死患者不良心血管事件的评估价值[J]. 东南大学学报(医学版), 2019, 38(5):843-847.
[11]	Artru F, Bou SM, Maggiotto F, et al. IL-33/ST2 pathway regulates neutrophil migration and predicts outcome in patients with severe alcoholic hepatitis[J]. J Hepatol, 2020, 72(6):1052-1061. doi: 10.1016/j.jhep.2019.12.017 URL
[12]	侯丽娟, 李玉华, 王宏伟, 等. 血清IL-33和sST2表达水平与慢性乙型肝炎患者病情相关性研究[J]. 中华医院感染学杂志, 2019, 29(10):1513-1516.
[13]	Wu Z, Dong XQ, Zhao H, et al. THU-242-clinical non-invasive markers for hepatic inflammation and fibrosis assessment in chronic hepatitis B with normal alanine aminotransferase[J]. J Hepatol, 2019, 70(1):e271-272.
[14]	徐静, 谭林, 高学武, 等. 红细胞分布宽度与血小板计数比值对慢性HBV感染者不同分期肝纤维化的诊断价值[J]. 山东医药, 2019, 59(32):72-75.
[15]	Udompap P, Sukonrut K, Suvannarerg V, et al. Prospective comparison of transient elastography, point shear wave elastography, APRI and FIB‐4 for staging liver fibrosis in chronic viral hepatitis[J]. J Viral Hepat, 2020, 27(4):437-448. doi: 10.1111/jvh.v27.4 URL