| Objective:By comparing the composition of degraded monosaccharide and free monosaccharide in serum of patients with degenerative valvular heart disease and healthy controls,to explore the distribution difference of serum monosaccharide in the disease and obtain the characteristic "glycan fingerprint" of the disease.To explore the significance of serum monosaccharide in the clinical evaluation of degenerative valvular disease.Methods:Patients diagnosed with degenerative valvular heart disease in the Affiliated Hospital of Qingdao University from June 2020 to July 2021 were collected to form a case group.The control group was selected from the outpatients who underwent physical examination in the Affiliated Hospital of Qingdao University at the same time according to gender and age.The clinical data and serum samples of all the enrolled people were collected.After the serum was degraded with the aid of hydrochloric acid,the monosaccharides in the serum samples of degenerative valvular disease group and health examination group were quantitatively detected by HPLC.Mann Whitney U test was used to compare the concentrations of degraded monosaccharide and free monosaccharide in serum samples of valve disease group and control group,cardiac function class I-II group and cardiac function class III-IV group.Logistic regression analysis was used to construct a diagnostic model based on serum monosaccharides.The ROC curve was used to evaluate the value of serum free monosaccharide and monosaccharide degradation in the diagnosis of valvular disease and the ability to differentiate cardiac function.Results:312 patients were included in the analysis,including 156 patients with degenerative valvular disease.The distribution of serum free and degraded monosaccharides was different between the health examination group and the degenerative valvular disease group.There were significant differences in mannose,glucosamine,galactose,fucose,free mannose,free glucose and the ratio of free glucose to free mannose between the valve disease group and the health examination group(p< 0.05).Fucose and mannose increased significantly in degenerative valvular disease group and galactose.The ratio of free glucose to free mannose decreased in degenerative valvular disease group.After grouping degenerative valvular disease according to cardiac function,it was found that there were significant differences in serum mannose,glucosamine,free mannose,free glucose and the ratio of free glucose to free mannose between the two groups,indicating that serum monosaccharide can objectively reflect the state of cardiac function to a certain extent.The logistic mathematical diagnostic model modle1 constructed by free and degraded monosaccharides in serum has good diagnostic value for degenerative valvular disease.The sensitivity,specificity and Area Under Curve of the diagnostic modle2 in distinguishing grade I-II and III-IV of heart function in patients with degenerative valvular disease were79.2%,69.2% and 0.798 respectively.Conclusion:1 There were significant differences in monosaccharide distribution between patients with degenerative valvular disease and healthy people.They form a unique glycan fingerprint of the disease.2 The combination of serum monosaccharide can be used as a candidate biomarker for the diagnosis of degenerative valvular disease.3 The difference of serum monosaccharide reflected the different cardiac function in patients with degenerative valvular disease. |
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