Serum FGF-21 and ET-1:Their value in evaluating the condition of pediatric EV71 hand,foot,and mouth disease and their correlation with fecal viral clearance time
Cang Min
Long Guangfeng
Xie Guojin
Abstract：Objective To investigate the value of serum fibroblast growth factor 21(FGF-21)and endothelin-1(ET-1)in assessing the severity of enterovirus 71(EV71)hand,foot,and mouth disease(HFMD)in children,and their impact on the time for fecal viral nucleic acid to turn negative.Methods A prospective study was conducted,enrolling 80 children with EV71 HFMD treated at our hospital as research subjects.Based on clinical manifestations,the children were divided into a mild group(40 cases),a severe group(30 cases),and a critical group(10 cases).Additionally,40 healthy children undergoing routine physical examinations during the same period were selected as a control group.Serum levels of FGF-21 and ET-1 were measured in all subjects,and EV71 viral nucleic acid in feces was detected.Differences in serum FGF-21 and ET-1 levels among the groups and their correlations with clinical indicators were analyzed,and their effects on the time for fecal viral nucleic acid to turn negative were evaluated.Results Clinical data were collected from 80 pediatric patients with EV71-associated HFMD and 40 healthy children.Children with HFMD had higher body temperature,WBC,CRP,and blood sugar levels than the healthy control group(P<0.001).Serum FGF-21 and ET-1 levels in children with HFMD were significantly higher than those in the healthy control group(P<0.001);with the aggravation of the disease,serum FGF-21 and ET-1 levels gradually increased,critical group>severe group>mild group(P<0.001).Serum FGF-21 and ET-1 levels in children with HFMD were significantly higher than those in healthy controls(P<0.001);as the disease worsened,serum FGF-21 and ET-1 levels gradually increased,with the critical group>severe group>common group(P<0.001).Serum FGF-21 and ET-1 levels were positively correlated with body temperature,WBC,CRP,and blood glucose(r=0.652,0.584,0.721,0.563;all P<0.001).In severe and critical cases,serum FGF-21 and ET-1 levels were positively correlated with WBC in cerebrospinal fluid(r=0.674,P<0.001).Serum FGF-21 and ET-1 levels were positively correlated with the time for viral nucleic acid in feces to turn negative(r=0.715 and 0.683,respectively,P<0.001).ROC curve analysis showed that the area under the curve(AUC)for serum FGF-21 in predicting severe EV71-associated HFMD was 0.862(95%CI:0.789-0.935),with a sensitivity of 85.0%and specificity of 82.5%;for ET-1,the AUC was 0.837(95%CI:0.758-0.916),with a sensitivity of 82.5%and specificity of 80.0%.Multivariate logistic regression analysis revealed that serum FGF-21 and ET-1 levels were independent risk factors for the progression of EV71-associated HFMD(OR=1.928,1.754;P<0.001).Conclusion Serum FGF-21 and ET-1 levels are associated with the severity of EV71 HFMD in pediatric patients.These markers can serve as effective biomarkers for assessing the severity of EV71 HFMD and determining the time to negative fecal viral nucleic acid conversion.They hold clinical significance for disease prognosis assessment and optimization of clinical treatment strategies.
Keywords：fibroblast growth factor 21endothelin-1enterovirus 71handfoot and mouth diseasechildrenbiomarkerstime to negative fecal virus nucleic acid
Publication Date：2025-12-30
Online Publishing Date：2025-12-30(First online date of this platform, not the publication date of the document)
Pages：6( 591-596 )