The relationship between serum lipid carrier protein 2 and kruppel like factor 15 with cardiac function and prognosis in patients with coronary heart disease
GUO Li-yan
LI Jun-xia
HAN Hong-feng
CHEN Jia-lei
LI Xuan-xuan
Abstract：Objective To analyze the relationship between serum lipid carrier protein 2(LCN2),Kruppel like factor 15(KLF15)expression,cardiac function,and prognosis in patients with coronary heart disease(CHD).Method 200 CHD patients diagnosed at the First Hospital of Handan City from January 2022 to January 2024 were selected for the study(CHD group).According to cardiac function,they were divided into GradeⅠgroup(n=80),GradeⅡgroup(n=73),and GradeⅢgroup(n=47).Based on the prognosis 6 months after surgery,they were divided into poor group(n=50)and good group(n=150).Another 200 healthy individuals who underwent physical examinations during the same period were selected as the control group.Collect the basic information such as age,gender and past medical history of the subjects with CHD and the control group.The levels of serum LCN2 and KLF15 before the operation,one month after the operation and three months after the operation were detected by enzyme-linked immunosorbent assay kit.The correlation between LCN2,KLF15 and cardiac function was analyzed by Pearson method.Multivariable Logistic regression was performed to determine whether LCN2 and KLF15 are independent influencing factors after adjusting for potential confounders.Receiver operating characteristic(ROC)curve analysis was used to evaluate the prognostic predictive performance of LCN2 and KLF15.Bootstrap resampling was conducted to validate the stability and reproducibility of the ROC model.Decision curve analysis(DCA)was employed to assess the clinical utility and decision supporting value of the model in terms of net benefit.Results The preoperative KLF15 of patients in the CHD group was lower than that of the control group[(3.54±0.42)ng/ml vs.(7.21±1.24)ng/ml,P<0.05],and the preoperative LCN2 was higher than that of the control group[(5.17±1.21)ng/ml vs.(2.32±0.35)ng/ml,P<0.05].Left ventricular ejection fraction(LVEF)[(56.31±10.38)%vs.(47.29±6.89)%vs.(40.58±5.16)%,P<0.05]and preoperative KLF15[(4.86±0.67)ng/ml vs.(3.37±0.36)ng/ml vs.(1.56±0.16)ng/ml,P<0.05]gradually decreased in groups Ⅰ,Ⅱ,and Ⅲ,while left ventricular end-systolic dimension[(4.86±0.67)ng/ml vs.(3.37±0.36)ng/ml vs.(1.56±0.16)ng/ml,P<0.05],left ventricular end-diastolic dimension[(LVEDD)(48.29±3.74)mm vs.(51.28±5.02)mm vs.(56.54±6.31)mm,P<0.05],brain natriuretic peptide(BNP),and LCN2[(3.46±0.12)ng/ml vs.(5.39±0.46)ng/ml vs.(7.74±1.35)ng/ml,P<0.05)]gradually increased(P<0.05).LCN2 was negatively correlated with LVEF(r=-0.358,P<0.05)and positively correlated with LVESD,LVEDD,and BNP(r=0.296,0.337,0.415,P<0.05).Preoperative KLF15 was positively correlated with LVEF(r=0.406,P<0.05)and negatively correlated with LVESD,LVEDD,and BNP(r=-0.318,-0.354,-0.372,P<0.05).The poor group had lower LVEF[(39.97±5.56)%vs.(52.43±9.57)%,P<0.05]and preoperative KLF15[(1.67±0.45)ng/ml vs.(4.17±0.92)ng/ml,P<0.05],and higher LVESD[(41.24±4.89)mm vs.(28.34±3.61)mm,P<0.05]、LVEDD[(56.81±6.21)mm vs.(49.50±4.39)mm,P<0.05],BNP,and preoperative LCN2[(7.59±1.44)ng/ml vs.(4.36±1.02)ng/ml,P<0.05]than the good group(P<0.05).Multivariate Logistic results showed that after adjusting for LVEF,LVESD,LVEDD and BNP,preoperative LCN2(OR=1.982,95%CI 1.579-2.488,P<0.05)and preoperative KLF15(OR=0.742,95%CI 0.620-0.889,P<0.05)were prognostic factors.ROC curve showed that the area under the curve(AUC)of preoperative LCN2,preoperative KLF15,and their joint in predicting prognosis was 0.845,0.855,and 0.926,respectively,with the joint being higher than the use alone(Zjoint vs.preoperative LCN2=3.072,P=0.002;Zjoint vs.preoperative KLF15=2.193,P=0.028).Internal validation results showed that χ2=2.367 and P=0.821,indicating good model consistency.The DCA curve results show that when the high-risk threshold is 0.28 to 0.96,the net benefit rate of the combined prediction of prognosis by preoperative serum LCN2 and KLF15 is relatively high.Conclusion Preoperative LCN2 and KLF15 are associated with changes in cardiac function and prognosis in CHD patients.And the combination of preoperative LCN2 and KLF15 exhibits high predictive efficacy for the prognosis of CHD patients.
Keywords：Coronary heart diseaseCardiac functionPrognosisLipocalin 2Kruppel like factor 15
Publication Date：2025-12-20
Online Publishing Date：2026-01-04(First online date of this platform, not the publication date of the document)
Pages：7( 1108-1114 )