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Serum Ceruloplasmin Is the Candidate Predictive Biomarker for Acute Aortic Dissection and Is Related to Thrombosed False Lumen: a Propensity Score–Matched Observational Case–Control Study

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Abstract

Acute aortic dissection (AAD), one of the fatal diseases observed at the department of vascular surgery, is associated with a great mortality rate at the early stage. Ceruloplasmin (CP) is the plasma protein that functions as a copper transporter. The current retrospective research was carried out to assess CP contents and to examine the possible part in diagnosing patients with AAD. In addition, propensity score matching (PSM) was also utilized for reducing the bias in case screening as well as the clinical confounders. Using PSM, this study included 85 pairs of AAD cases (Stanford A and B dissection) and matched controls, and their CP levels were also detected through enzyme-linked immunosorbent assay (ELISA). Additionally, the relative clinical data were extracted from participants included in this study. After PSM adjustment for clinical variables, including gender, age, body mass index (BMI), heart ratio (HR), smoking, hypertension, diabetes mellitus, coronary heart disease (CHD), and stroke, the serum CP contents among AAD cases were remarkably increased compared with those among the normal subjects. Besides, the CP contents showed independent association with the AAD risk. Typically, the CP level was significantly positively correlated with platelet (R = 0.329) or C-reactive protein (R = 0.340) level. Meanwhile, the area under the receiver operating characteristic (ROC) curve (AUC) was 0.929 when CP was used to diagnose AAD, and the best threshold value was 36.82mg/dL. Serum CP content significantly increased in cases with thrombosed false lumen (FL) relative to those in patent FL cases. Results of logistic regression analysis suggested that a greater CP content indicated an increased thrombosed FL risk (OR = 1.11; 95% CI: 1.01–1.23; P = 0.040). Findings in this study suggest that serum ceruloplasmin contents evidently increased among acute aortic dissection cases. CP shows close correlation with the inflammatory factors among AAD cases. Further, CP may serve as the candidate biomarker to diagnose AAD and to identify an increased risk of thrombosed false lumen.

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Data Availability

Changcheng Ma and Yanshuo Han collected blood sample and biobank. Changcheng Ma and Yanshuo Han conducted the experiment. Feng Shi and Yanshuo Han collected clinical data. Chao Ji and Yanshuo Han performed the analysis and drafted the manuscript. Haibin Zhao and Yanshuo Han designed the study and revised the manuscript. All authors read and approved the final manuscript.

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Funding

This work was supported by the Fundamental Research Funds for the Central Universities (grant number: DUT19RC(3)076), the National Natural Science Foundation of China (grant number: 81600370), and the China Postdoctoral Science Foundation (grant number: 2018M640270) for Yanshuo Han.

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Authors and Affiliations

  1. Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang, China

    Changcheng Ma

  2. Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, China

    Haibin Zhao

  3. Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, China

    Feng Shi

  4. Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China

    Mu Li & Xun Liu

  5. Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China

    Chao Ji

  6. School of Life and Pharmaceutical Sciences, Dalian University of Technology, No. 2 Dagong Road, Liaodongwan New District, Panjin, 124221, China

    Yanshuo Han

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  4. Mu Li
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Contributions

Manuscript review as well as eventual approval: Changcheng Ma, Chao Ji, and Yanshuo Han.

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Correspondence to Yanshuo Han.

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Conflict of Interest

The authors declare that they have no conflict interests.

Ethical Approval

The study protocol was approved by the Ethics Committee of Shengjing Hospital of China Medical University(Ethics Approval No. 2016PS085K) according to the Declaration of Helsinki.

Consent to Participate

Each of the 85 AD patients and 85 controls had provided the written informed consent to participate in this study.

Consent for Publication

Each of the 85 AD patients and 85 controls had provided the written informed consent for publication. Six cases were excluded due to their unwillingness to offer the inpatient records for publication.

Code Availability

SJH-AADBB/CMU and SJH-MED/CMU Blood Biobank data that support the findings of this study have been deposited in Department of Laboratory Medicine, Shengjing Hospital of China Medical University with the accession codes [macc].

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Ma, C., Zhao, H., Shi, F. et al. Serum Ceruloplasmin Is the Candidate Predictive Biomarker for Acute Aortic Dissection and Is Related to Thrombosed False Lumen: a Propensity Score–Matched Observational Case–Control Study. Biol Trace Elem Res 199, 895–911 (2021). https://doi.org/10.1007/s12011-020-02219-3

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