Abstract

Several diseases have a deleterious fibrosis component. Biomarkers indicating potential clinical utility that reliably reflect the degree of fibrosis have been introduced, one of them being soluble suppression of tumorigenicity 2 (sST2). The aim of our study was to explore the association of cardiometabolic risk factors, different diseases and total mortality with biomarker sST2 and see, how fibrosis is portrayed in these conditions. In addition, we were interested to see if sST2 levels could predict fibrosis in the long-term (21 years). The Oulu Project Elucidating Risk of Atherosclerosis (OPERA) survey collected data on the same individuals in years 1991–1993 (baseline, n = 1045), 2013–2014 (follow-up, n = 600) and mortality data until year 2019. Smoking at baseline retained a significant association with sST2 levels reflecting fibrosis development 20 years later. In the multivariate model male gender, diabetes, quick-index, levels of alanine aminotransferase (ALAT), high-density lipoprotein (HDL) cholesterol and high-sensitivity C-reactive protein (hsCRP) were associated with elevated sST2 levels at the examination 2013–2014. sST2 levels were higher among subjects suffering from cardiovascular disease (p = .031), cancer (p = .021), mild cognitive decline (p = .046) and diabetes (p < .001). Total mortality was assessed by using the Cox proportional hazard survival model analysis. sST2 (log-transformed) was an independent predictor of total mortality (HR 9.4; 95% CI 2.8–31.4, p<.001) when age, gender, diabetes, smoking, quick-index, levels of ALAT, HDL-cholesterol and hsCRP were added as covariates. In addition, elevated levels indicated worse prognosis and predicted mortality.

摘要

几种疾病具有有害的纤维化成分。已经引入了指示可靠反映纤维化程度的潜在临床效用的生物标志物，其中之一是致瘤性2（sST2）的可溶性抑制。我们研究的目的是探索心脏代谢危险因素、不同疾病和总死亡率与生物标志物 sST2 的关系，并了解在这些情况下如何描述纤维化。此外，我们有兴趣了解 sST2 水平是否可以预测长期（21 年）的纤维化。奥卢项目阐明动脉粥样硬化风险 (OPERA) 调查收集了 1991-1993 年（基线，n  = 1045）、2013-2014 年（随访，n = 600) 和直到 2019 年的死亡率数据。基线吸烟与反映 20 年后纤维化发展的 sST2 水平保持显着相关性。在多变量模型中，男性、糖尿病、快速指数、丙氨酸氨基转移酶 (ALAT)、高密度脂蛋白 (HDL) 胆固醇和高敏 C 反应蛋白 (hsCRP) 水平与 2013 年考试中 sST2 水平升高相关–2014 年。患有心血管疾病 ( p  = .031)、癌症 ( p = .021)  、轻度认知衰退 ( p  = .046) 和糖尿病 ( p < .001)。通过使用 Cox 比例风险生存模型分析评估总死亡率。当年龄、性别、糖尿病、吸烟、快速指数、 ALAT 、 HDL-胆固醇和hsCRP 作为协变量添加。此外，升高的水平表明预后和预测死亡率较差。