Relationship Between Plasma GDF-15 And SST2 Level And Chronic Cardio-renal Syndrome And Its Clinical Significance

Objectivechronic cardio-renal syndrome usually causes the elevation of plasma biomarkers,and in recent years,new biomarkers such as plasma growth differentiation factor 15 and soluble growth stimulation expressed gene 2 have attracted widespread attention.This study aims to investigate the relationship between plasma levels of GDF-15 and s ST2 in patients with chronic cardio-renal syndrome,and to evaluate their clinical value.MethodsA total of 114 patients with chronic heart failure admitted to the First Affiliated Hospital of Dali University from April 2022 to October 2022 were collected.According to the estimated glomerular filtration rate,they were divided into 63 patients with chronic cardio-renal syndrome(e GFR<60 ml/min/1.73m~2)and 51 patients with chronic heart failure(e GFR≥60 ml/min/1.73m~2).Select healthy examinees in the same period as the control group(n=49 cases)Record the general information and biochemical indicators of all research subjects,use enzyme-linked immunosorbent assay to detect plasma levels of GDF-15 and s ST2,and perform echocardiography examination.All data of the three groups of study subjects were collected and statistically analyzed using SPSS27.0 statistical software to analyze the correlation between plasma GDF-15 and s ST2 levels and renal function,as well as cardiac structure and function in patients with chronic cardio-renal syndrome.Results1.Comparison of general clinical data:There was no significant difference in sex,smoking,drinking,body mass index,heart rate and blood pressure among chronic CRS group,CHF group and control group(P>0.05).Chronic CRS group was older,and the difference was statistically significant compared with CHF group and control group(P<0.05).2.Comparison of laboratory indicators:There were no significant differences in blood cell analysis,fasting blood glucose,ALT,TBI and IBI among chronic CRS group,CHF group and control group(P>0.05).AST and DBI of chronic CRS group and CHF group were higher than those of control group,while ALB,TC and TG of chronic CRS group were lower than those of control group,and the difference was statistically significant(P<0.05).Cr,Urea and UA in chronic CRS group were higher than those in CHF group and control group,and the difference was statistically significant(P<0.05).There was no significant difference in renal function between CHF group and control group(P>0.05).3.Compared with the control group,the chronic CRS group and CHF group showed an increase in BNP,LVEDD,LVESD,and a decrease in LVEF,with statistically significant differences(P<0.05).There was no statistically significant difference in the above indicators between the chronic CRS group and the CHF group(P>0.05).4.The levels of GDF-15 and s ST2 in chronic CRS group and CHF group were significantly higher than those in control group,and the differences among groups were statistically significant(P<0.05).5.According to NYHA grading standards,chronic CRS patients were divided into three groups(Grade II,III,IV).Compared with the plasma GDF-15 level,the lowest was found in Grade II patients and the highest was found in grade IV patients,and the difference was statistically significant(P<0.05).There was no significant difference in plasma s ST2 level between groups(P>0.05).6.Patients with chronic CRS were divided into 3 groups(stage 3,stage 4,and Stage5)according to CKD stage,and there was no significant difference in plasma GDF-15and s ST2 levels between groups(P>0.05).7.Correlation analysis found that plasma GDF-15 and s ST2 levels were positively correlated with BNP,LVEDD,LVESD,Cr,Urean and UA(P<0.05),and negatively correlated with LVEF(P<0.05).8.The area under the ROC curve of plasma GDF-15 for the diagnosis of chronic cardio-renal syndrome was 0.87(95%CI:0.82-0.92),and its sensitivity and specificity were 79.4%and 81%respectively.The area under the ROC curve of plasma s ST2 for the diagnosis of chronic cardio-renal syndrome was 0.83(95%CI:0.77-0.89),and its sensitivity and specificity were 77.8%and 76%respectively.when GDF-15 and s ST2were combined,the area under the ROC curve was 0.91(95%CI:0.87-0.96),and its sensitivity and specificity were 90.5%and 81%respectively.Conclusions1.Plasma GDF-15 and s ST2 were positively correlated with cardiac structure and renal function indicators LVEDD,LVESD,LVEF,Cr,Urea and UA,and negatively correlated with cardiac function indicators BNP.2.Plasma GDF-15 and s ST2 have diagnostic value for chronic cardio-renal syndrome.Combined plasma GDF-15 and s ST2 detection can improve the diagnostic effectiveness of chronic cardio-renal syndrome.