Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2019, Vol. 15 ›› Issue (06): 688 -694. doi: 10.3877/cma.j.issn.1673-5250.2019.06.013

Special Issue:

Original Article

Relationship between serum levels of growth differentiation factor-15, heart-fatty acid-binding protein, brain natriuretic peptide and prognosis in children with pneumonia associated with heart failure

Qingtao Li1, Hongyun Chen2, Liyuan Tian1,()   

  1. 1. Department of Respiratory, Children′s Hospital of Hebei Province, Shijiazhuang 050031, Hebei Province, China
    2. Department of Pediatrics, Nanpi County People′s Hospital, Cangzhou 061500, Hebei Province, China
  • Received:2019-06-24 Revised:2019-11-08 Published:2019-12-01
  • Corresponding author: Liyuan Tian
  • About author:
    Corresponding author: Tian Liyuan, Email:
  • Supported by:
    Key Project Plan of Medical Science Research of Hebei Province in 2018(20180628)
Objective

To investigate the relationship between serum levels of growth differentiation factor (GDF)-15, heart-fatty acid-binding protein (H-FABP) and brain natriuretic peptide (BNP) and the prognosis of children with pneumonia associated with heart failure (HF).

Methods

Eighty children with pneumonia associated with HF diagnosed in Children′s Hospital of Hebei Province from May 2016 to May 2018 were selected as research subjects and were enrolled into study group. And 80 healthy children who received child care in the same hospital during the same period were selected as control and were enrolled into control group. The serum levels of GDF-15, H-FABP, BNP and HF marker proteins cardiac troponin (cTnI) and creatine kinase (CK)-MB of two groups were detected by enzyme-linked immunosorbent assay (ELISA) and compared by independent-samples t test. Pearson correlation analysis was used to analyze the correlation between serum levels of GDF-15, H-FABP, BNP and HF marker protein cTnI and CK-MB. Cox proportional hazard model was used to analyze the relationship between serum levels of GDF-15, H-FABP, BNP and prognosis of children with pneumonia associated with HF. The procedures followed in this study met the requirements of World Association Declaration of Helsinki revised in 2013. The guardians of all research subjects signed clinical research informed consent. There were no statistical differences between two groups in the general clinical data, such as gender composition ratio, birth gestational age, birth age, age and so on.

Results

①The serum levels of GDF-15, H-FABP, BNP, cTnI and CK-MB in study group were (5.01±0.73) ng/mL, (36.2±6.2) ng/mL, (899.8±300.3) pg/mL, (0.31±0.10) μg/L, and (36.2±5.3) U/L, respectively, which all were statistically higher than those in control group (0.59±0.10) ng/mL, (1.2±0.3) ng/mL, (21.4±4.3) pg/mL, (0.06±0.02) μg/L, (18.4±2.6) U/L, and all the differences were statistically significant (t=53.652, 50.432, 26.164, 21.931, 26.973, all P<0.001). ②Among children with pneumonia associated with HF, the serum levels of GDF-15 and BNP of both were positively correlated with serum level of cTnI (r=0.340, P=0.002; r=0.285, P=0.010). And the serum levels of GDF-15 and H-FABP both were positively correlated with serum level of CK-MB (r=0.765, P<0.001; r=0.302, P=0.006). ③Cox proportional hazard model analysis results showed that the risk of poor prognosis in children with high expression of serum GDF-15 was 2.319 times higher than that in children with low expression of serum GDF-15 (HR=2.319, 95%CI: 1.306-4.118, P=0.004). The risk of poor prognosis in children with high expression of serum H-FABP was 1.737 times higher than that in children with low expression of serum H-FABP (HR=1.737, 95%CI: 1.027-2.937, P=0.039). The risk of poor prognosis in children with high expression of serum BNP was 1.904 times higher than that in children with low expression (HR=1.904, 95%CI: 1.135-3.195, P=0.015).

Conclusions

Serum levels of GDF-15, H-FABP and BNP of children with pneumonia associated with HF are increased, and they are associated with poor prognosis of children with this disease. As the sample size in this study is relatively small, the relationships between these three indexes and the prognosis of children with pneumonia associated with HF, and its value in evaluating the prognosis of this disease, remain to be further confirmed by large-sample, multi-center, and randomized controlled trials.

表1 2组受试儿一般临床资料比较
表2 2组受试儿血清GDF-15、H-FABP、BNP、cTnI及CK-MB水平比较(±s)
图6 肺炎合并HF患儿血清BNP水平与血清CK-MB水平的相关性分析
表3 肺炎合并HF患儿预后影响因素的Cox比例风险回归模型分析的变量含义及其赋值
表4 肺炎合并HF患儿预后影响因素的Cox比例风险回归模型分析结果
[1]
万燕婷,廖凤玲,李薇. 5岁以下儿童支原体肺炎的流行病学调查及相关影响因素[J]. 山西医药杂志,2018, 47(8): 868-870.
[2]
Peddoju S, Kavitha K, Sharma SC. Big data analytics for childhood pneumonia monitoring[M]// Bhatt C, Peddoju SK. Cloud computing systems and applications in healthcare. Pennsylvania: IGI Global, 2016: 1129-1145.
[3]
Yang LD, Chang CC, Sun Z, et al. GFRAL is the receptor for GDF15 and is required for the anti-obesity effects of the ligand [J]. Nat Med, 2017, 23(10): 1158-1166.
[4]
Mueller T, Leitner I, Egger M, et al. Association of the biomarkers soluble ST2, galectin-3 and growth-differentiation factor-15 with heart failure and other non-cardiac diseases[J]. Clin Chim Acta, 2015, 445(20): 155-160.
[5]
Savin M, Mihailescu CM, Matei I, et al. A quantum dot-based lateral flow immunoassay for the sensitive detection of human heart fatty acid binding protein (hFABP) in human serum[J]. Talanta, 2018, 178: 910-915.
[6]
Zhou FJ, Zhou CY, Tian YJ, et al. Diagnostic value of analysis of H-FABP, NT-proBNP, and cTnI in heart function in children with congenital heart disease and pneumonia[J]. Eur Rev Med Pharmacol Sci, 2014, 18(10): 1513-1516.
[7]
Saenger AK, Rodriguez-Fraga O, Ler R, et al. Specificity of B-type natriuretic peptide assays: cross-reactivity with different BNP, NT-proBNP, and proBNP peptides[J]. Clin Chem, 2017, 63(1): 351-358.
[8]
Iacob D, Butnariu A, Leucuţa DC, et al. Evaluation of NT-proBNP in children with heart failure younger than 3 years old[J]. Rom J Intern Med, 2017, 55(2): 69-74.
[9]
吴瑞萍,胡亚美,江载芳. 诸福棠实用儿科学[M]. 8版. 北京:人民卫生出版社,2015: 1342-1345.
[10]
Alshaarawy O, Anthony JC. Cannabis smoking and serum C-reactive protein: a quantile regressions approach based on NHANES 2005-2010[J]. Drug Alcohol Depend, 2015, 147: 203-207
[11]
Thomsen RW, Kasatpibal N, Riis A, et al. The impact of pre-existing heart failure on pneumonia prognosis: population-based cohort study[J]. J Gen Intern Med, 2008, 23(9): 1407-1413.
[12]
Gottlieb SS, Khatta M, Friedmann E, et al. The influence of age, gender, and race on the prevalence of depression in heart failure patients[J]. J Am Coll Cardiol, 2004, 43(9): 1542-1549.
[13]
朱晓华,李岚,李建,等. 红细胞分布宽度与婴幼儿肺炎病情严重程度的关系[J]. 南昌大学学报(医学版), 2017, 57(2): 27-28, 33.
[14]
高凤霞. 儿童社区获得性肺炎[J]. 海南医学,2005, 16(11):128-129.
[15]
Tran T, Yang JP, Gardner J, et al. GDF15 deficiency promotes high fat diet-induced obesity in mice[J]. PLoS One, 2018, 13(8): e0201584.
[16]
Sharma A, Stevens SR, Lucas J, et al. Utility of growth differentiation factor-15, a marker of oxidative stress and inflammation, in chronic heart failure: insights from the HF-ACTION study[J]. JACC Heart Fail, 2017, 5(10): 724-734.
[17]
Song HJ, Yin DL, Liu ZH. GDF-15 promotes angiogenesis through modulating p53/HIF-1α signaling pathway in hypoxic human umbilical vein endothelial cells[J]. Mol Biol Rep, 2012, 39(4): 4017-4022.
[18]
Sato E, Kamijo-Ikemori A, Oikawa T, et al. Urinary excretion of liver-type fatty acid-binding protein reflects the severity of sepsis[J]. Ren Replacem Ther, 2017, 3(1): 26.
[19]
Jones JD, Chew PG, Dobson R, et al. The prognostic value of heart type fatty acid binding protein in patients with suspected acute coronary syndrome: a systematic review[J]. Curr Cardiol Rev, 2017, 13(3): 189-198.
[20]
Baggen VJ, van den Bosch AE, Eindhoven JA, et al. Prognostic value of N-terminal pro-B-type natriuretic peptide, troponin-T, and growth-differentiation factor 15 in adult congenital heart disease[J]. Circulation, 2017, 135(3): 264-279.
[21]
Lu A, Disoma C, Zhou YZ, et al. Protein interactome of the deamidase phosphoribosylformylglycinamidine synthetase (PFAS) by LC-MS/MS[J]. Biochem Biophys Res Commun, 2019, 513(3): 746-752.
[22]
Pufulete M, Maishman R, Dabner L, et al. B-type natriuretic peptide-guided therapy for heart failure (HF): a systematic review and Meta-analysis of individual participant data (IPD) and aggregate data[J]. Syst Rev, 2018, 7(1): 112.
[23]
De Vecchis R, Esposito C, Di Biase G, et al. B-type natriuretic peptide-guided versus symptom-guided therapy in outpatients with chronic heart failure: a systematic review with Meta-analysis[J]. J Cardiovasc Med (Hagerstown), 2014, 15(2): 122-134.
[24]
Davarzani N, Sanders-van Wijk S, Karel J, et al. N-terminal Pro-B-type natriuretic peptide-guided therapy in chronic heart failure reduces repeated hospitalizations-results from TIME-CHF[J]. J Card Fail, 2017, 23(5): 382-389.
[25]
Felker GM, Anstrom KJ, Adams KF, et al. Effect of natriuretic peptide-guided therapy on hospitalization or cardiovascular mortality in high-risk patients with heart failure and reduced ejection fraction: a randomized clinical trial[J]. JAMA, 2017, 318(8): 713-720.
[1] Hongyu Tao, Jingjing Ye, Jin Yu, Xiuzhen Yang, Jingjing Qian, Bin Xu, Weize Xu, Qiang Shu. Value of contrast transthoracic echocardiography in assessing right-to-left shunt-related diseases in children[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(10): 959-965.
[2] Xiaofei Li, Hongli Liu, Qiuling Shi, Jing Tian, Li Li, Hongbo Qi, Xin Luo. A prospective randomized controlled study of low intensity focused ultrasound uterine involution treatment for prevention and treatment of postpartum hemorrhage in natural childbirth women[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(05): 534-539.
[3] Qin Liu, Hanmin Liu, Liang Xie. Current status of research on the role of matrix metalloproteinases in the pathogenesis of childhood asthma[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(05): 564-568.
[4] Yun Xiang, You Lu, Fan Yang. Current research status of correlation between per-and polyfluoroalkyl substances exposure and childhood obesity[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(05): 569-574.
[5] Yuxiao Zhang, Fan Yang, Meng Mao. Interpretation of Catch-Up Growth in Infants and Young Children with Faltering Growth:Expert Opinion to Guide General Clinicians[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(04): 361-366.
[6] Mengsi Zhang, Yiqun Ma, Lijuan Meng, Hui Zhu, Jinfeng Fu. Observation on the effect of the combined use of pressure gloves, webbed finger compression straps and foam silicone gel sheeting after surgery in children with cicatricial syndactyly[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2024, 19(04): 329-334.
[7] Xiaoli Yang, Wanfu Li, Zhu Ma, Lan Ma, Yi Zheng, Xiaoli Fu, Jing Wang. Application effect of one-step forceps needle method in laparoscopic high ligation of hernia sac in children[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 535-538.
[8] Hebei Ding, Xun Wang, Weiguo Chen. Comparison of application of sevoflurane inhalation anesthesia and propofol intravenous anesthesia in pediatric indirect inguinal hernia surgery[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(05): 570-574.
[9] Chinese Society of Organ Transplantation of Chinese Medical Association, Surgery Group of Chinese Society of Surgery of Chinese Medical Association, Transplantation Group of Chinese Society of Surgery of Chinese Medical Association, South China Alliance of Split Liver Transplantation. Chinese Clinical Practice Guidelines on Split Liver Transplantation in Children[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(05): 593-601.
[10] Jun Liu, Wenjing Qiu, Fanghao Sun, Songying Li, Shuhong Yi, Binsheng Fu, Yang Yang, Hui Luo. Comparison of in vivo and in vitro split liver transplantation in pediatric liver transplantation[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(05): 688-693.
[11] Jiachen Zhang, Hongxin Song. The correlation between the changes of spherical equivalent and myopia progression in children with refractive error[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2024, 14(04): 217-222.
[12] Chen Zhang, Ming Qin, Juan Dong, Yulong Chen. Diagnostic value of ultrasound in ischemic changes of intestinal volvulus in children[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(06): 565-568.
[13] Xiaoyu Wang, Qunying Guo, Yameng Niu, Chengsong Zhao. Practice of promoting equal access to pediatric medical care in public children's hospitals[J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(04): 383-387.
[14] Xiaosheng Chen, Jia He, Fang Liu, Rui Wu, Haitao Yang, Xiaohan Fan. Pacemaker implantation in a child with a 31-second cardiac arrest induced by tilt table test: a case report and literature review[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(05): 488-494.
[15] Yali Cao, Yumeng Gao, Yingqian Zhang, Bo Li, Junbao Du, Hongfang Jin. Clinical progress of sitting intolerance in children[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(05): 510-515.
Viewed
Full text


Abstract