Diagnostic value of serum soluble growth stimulation expressed gene 2 and growth differentiation factor-15 and follistatin-like protein 1 in heart failure
ZHANG Yuan-yuan
ZHAO Zhi-jie
LIU Qing
LI Peng-fei
YUAN Wen-juan
SUN Mei-ling
LIU Xiao-ming
Abstract：Objective To explore the clinical value of combining test of serum soluble growth stimulation expressed gene 2(sST2),growth differentiation factor-15(GDF-15),and follistatin-like protein 1(FSTL1)in the diagnosis of heart failure patients.Methods A total of 145 heart failure patients admitted to Cangzhou People's Hospital from January 2022 to December 2023 were included as the heart failure group,another 145 volunteers without heart failure who came to our hospital for physical examinations were selected as the reference group.According to the New York Heart Association(NYHA)cardiac function classification,heart failure was separated into NYHA grade Ⅱ(48 cases),NYHA grade Ⅲ(76 cases),and NYHA grade Ⅳ(21 cases).Pearson correlation was applied to analyze the correlation between serum sST2,GDF-15,and FSTL1 levels.Multiple logistic regression analysis(stepforward method)was applied to screen for the factors that affected the occurrence of heart failure.The area under the curve(AUC)for the diagnosis of heart failure with the combination of serum sST2,GDF-15,and FSTL1 was obtained by plotting the receiver operating characteristic(ROC)curve and validated using Z-test.Results The serum levels of sST2,GDF-15,FSTL1 and N-terminal pro-B-type natriuretic peptide(NT-proBNP)in the heart failure grou were greatly higher than those in the reference group[(43.76±13.93)ng/ml vs.(32.48±10.25)ng/ml、(964.37±312.25)ng/L vs.(752.80±243.67)ng/L、(568.11±174.89)ng/L vs.(436.64±138.33)ng/L、(1627.04±476.53)pg/ml vs.(217.49±69.14)pg/ml,P＜0.05].The serum levels of sST2,GDF-15 and FSTL1 in NYHA grade Ⅳ and NYHA grade Ⅲ were greatly higher than those in NYHA grade Ⅱ(t=7.854,6.432,7.100,35.249,P＜0.05),while the serum levels of sST2,GDF-15,and FSTL1 in NYHA grade Ⅳ were greatly higher than those in NYHA grade Ⅲ(P＜0.05).The serum sST2 level was positively correlated with GDF-15 and FSTL1 levels in the heart failure group(r=0.502,0.508,P＜0.001),while the serum GDF-15 level was positively correlated with FSTL1 level(r=0.444,P＜0.001).The risk factors affecting heart failure included sST2,GDF-15,FSTL1 and NT-proBNP(P＜0.05).The AUC for combined diagnosis of heart failure with serum sST2,GDF-15 and FSTL1 was 0.886(95％CI 0.847-0.924),while the AUC for single diagnosis of heart failure with sST2,GDF-15 and FSTL1 was 0.810(95％CI 0.760-0.859),0.773(95％CI 0.721-0.826)and 0.773(95％CI 0.719-0.827),respectively;the combined diagnostic value of the three was higher than that of sST2(Z=2.374,P=0.018),GDF-15(Z=3.363,P=0.001)and FSTL1(Z=3.363,P=0.001)alone.Conclusion sST2,GDF-15 and FSTL1 are abnormally upregulated in the serum of patients with heart failure,and they are closely related to the grading of heart function.The combining test of them can improve the diagnostic value of heart failure.
Keywords：Heart failureSoluble growth stimulation expressed gene 2Growth differentiation factor-15Follistatin-like protein 1Diagnosis
Publication Date：2024-12-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1101-1106 )