Study On The Predictive Value Of SST2 In Chronic Kidney Disease Concurrency Heart Failure

Part 1Objective:Study will establish a Soluble cell growth stimulating gene 2 protein(sST2)biological reference interval suitable for different age groups of adult healthy people in Handan area.Methods:We selected 1080 people over 18 years old who were examined at the Health Examination Center of Handan Central Hospital from January 2021 to December 2022 as the reference population.Group according to the age group,detect the level of sST2 in each group,compare the difference between groups(P<0.05 is statistically significant),and establish the biological reference interval of serum sST2 in healthy adults in Handan area.Results:There was a statistically significant difference in the level of sST2 between the sex groups of healthy adults(P<0.05).There was a statistically significant difference in the level of sST2 among the healthy adult male groups(P<0.05).There was a statistically significant difference in the level of sST2 among the healthy adult female groups(P<0.05).After merging the groups,determine the upper limit of the reference interval for healthy adults,31.2ng/m L for males<40years old,23.7ng/m L for males≥40years old;20.3ng/m L for females<30years old and≥50years old,21.1ng/m L for females≥30 years old and<50 years old.Conclusions:This study established a reference range for sST2 in Handan area and found that the distribution of sST2 in healthy populations is related to age and gender.Part 2Objective:The study will explore the predictive ability of soluble cell growth stimulating gene 2 protein(sST2)to heart failure(HF)in patients with chronic kidney disease(CKD).Methods:Collect patients with different stages of CKD who were treated in Handan Central Hospital from January 2021 to January 2023,and collect their serum samples and medical record information.The correlation between sST2 and the occurrence of heart failure in patients with different CKD stages was studied by statistical analysis after detecting the serum level of sST2(the difference was statistically significant with P<0.05),and its predictive ability for the occurrence of heart failure in patients with different CKD stages was analyzed.Results:1.There was no statistically significant difference between the levels of serum sST2 in patients with CKD1-5(P=0.40525),and there was no significant correlation between the levels of serum sST2 and the CKD stage of patients(r=0.000986,P=0.9912).There was no significant correlation between the level of sST2 and the level of Scr(P>0.05).2.The serum level of sST2 in CKD patients without HF and cardiac function Ⅰ-Ⅳ was significantly higher than that in healthy control group(P<0.05).The higher the cardiac function grading,the higher the serum sST2 level gradually increased.There was a statistically significant difference between the two groups(P=0.00018).The serum sST2 level had a certain correlation with the cardiac function grading of patients(r=0.408,P<0.0001).3.There was no significant correlation between the serum level of sST2 and the cardiac function grading of patients in CKD1-3b phase(correlation coefficient r was-0.273,0.228,0.533,0.412;significant level P was 0.273,0.362,0.091,0.183 respectively);There was significant correlation between CKD4 and CKD5 and the cardiac function grading of patients(correlation coefficient r was 0.730 and 0.596,respectively;significant level P was<0.0001 and 0.0013,respectively).The AUC of sST2 in CKD4 and CKD5 were 0.838 and 0.778 respectively,and the significance level P was0.0001 and 0.0006 respectively.4.The patients in CKD5 stage with grade III and IV cardiac insufficiency were defined as positive,redraw the ROC curve,the AUC change was 0.932,P<0.001.Conclusions:1.The level of serum sST2 has no clinical value for the diagnosis of CKD and has no guiding significance for the stage of CKD.2.The level of serum sST2 increases with the increase of cardiac function grading,which has reference value for guiding cardiac function grading.3.The serum level of sST2 is significantly correlated with the changes of cardiac function in CKD stage 4 and 5,which has predictive value for the occurrence of HF in patients with CKD stage 4 and 5.4.In CKD5 stage,serum SST2 level has better predictive ability for III and IV grade changes of cardiac function.